Association between social deprivation and disease activity in rheumatoid arthritis: a systematic literature review

Dey, Mrinalini; Busby, Amanda; Elwell, Helen; Lempp, Heidi; Pratt, Arthur G.; Young, Adam; Isaacs, John D.; Nikiphorou, Elena

doi:10.1136/rmdopen-2021-002058

Cited by 25 publications

(27 citation statements)

References 42 publications

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“…Although several studies have described D2T RA-related factors in patients with RA17 30 31 with long-standing disease, the effect of different variables on this outcome has not been studied in the early stages of disease, and comparisons between them would not be accurate. In addition, consideration should be given to the possibility of other lifestyle, economics and non-modifiable sociodemographic factors that may contribute to the development of D2T RA 14 32–35…”

Section: Discussionmentioning

confidence: 99%

Difficult-to-treat rheumatoid arthritis (D2T RA): clinical issues at early stages of disease

et al. 2023

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ObjectivesMost studies on difficult-to-treat rheumatoid arthritis (D2T RA) have focused on established RA. Here, we analyse whether disease activity in the early stages of RA could influence progression to a D2T RA under real-life conditions. Other clinical and treatment-related factors were also analysed.MethodsA longitudinal multicentre study of patients with RA was conducted from 2009 to 2018. Patients were followed up until January 2021. D2T RA was defined based on EULAR criteria (treatment failure, signs suggestive of currently active/progressive disease and management being perceived as problematic by the rheumatologist and/or patient). The main variable was disease activity in the early stages. The covariates were sociodemographic, clinical and treatment-related factors. We ran a multivariable logistic regression analysis to investigate risk factors associated with progression to D2T RA.ResultsThe study population comprised 631 patients and 35 (5.87%) developed D2T RA. At the time of diagnosis, the D2T RA group were younger, with a higher disability, 28-joint Disease Activity Score (DAS28) score, tender joint count and pain scores. In our final model, DAS28 was not statistically significantly associated with D2T RA. No differences were found between groups for therapy. Disability was independently associated with D2T RA (OR: 1.89; p=0.01).ConclusionsIn this cohort of patients newly diagnosed with RA, our results do not allow us to prove the influence of active disease according to DAS28. However, we did find that younger patients and those with elevated initial disability scores are more likely to develop D2T RA regardless of other factors.

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Section: Discussionmentioning

confidence: 99%

Difficult-to-treat rheumatoid arthritis (D2T RA): clinical issues at early stages of disease

et al. 2023

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“…These studies have concluded that social isolation can lead to worsening of neuropsychiatric symptoms and motor function,35 36 although these effects are not restricted to PD 37. Evidence for the influence of social exclusion on health outcomes comes from other studies of chronic conditions, such as dementia,38 diabetes,39 HIV40 and rheumatoid arthritis 41…”

Section: Discussionmentioning

confidence: 99%

Social deprivation and exclusion in Parkinson’s disease: a cross-sectional and longitudinal study

Heimrich,

Schönenberg,

Prell

2023

BMJ Open

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ObjectiveTo describe prevalence and associated factors of social deprivation in people with Parkinson’s disease (PwPD).DesignCross-sectional and longitudinal cohort study.SettingData were taken from the Survey of Health, Ageing and Retirement in Europe (SHARE), a multidisciplinary, cross-national and longitudinal research project.ParticipantsCommunity-dwelling adults from waves 5 (2013, n=66 188) and 6 (2015, n=68 186) of the SHARE dataset. After longitudinal analyses, participants in wave 5 can be retrospectively divided into the following three subgroups: PwPD at wave 5 (n=559), people newly reported PD from wave 5 to wave 6 (prodromal PD; n=215) and people without PD (n=46 737).Outcome measuresThe prevalence and associated factors of social deprivation in PD, its impact on quality of life (QoL) and its onset within the course of PD.ResultsPwPD had higher indices for material and social deprivation than non-PD participants, and 20% of PwPD were at risk of social exclusion. Social deprivation alone accounted for 35% and material deprivation for 21% of QoL variance and remained significant predictors of QoL after adjustment for cofactors. Social deprivation and risk of social exclusion were already increased in people with prodromal PD, and accordingly preceded PD diagnosis in wave 6.ConclusionsFor the treatment of PD, we should consider the impact of social deprivation and exclusion on QoL and their association with mental and physical functioning. However, the relevance of social deprivation as a prodromal phenomenon requires further investigation.

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“…For instance, investigations into cardiovascular disease49 50 have revealed how socioeconomic disparities can affect disease risk. Similarly, studies on rheumatoid arthritis51 have shed light on the interplay between socioeconomic status and deprivation and disease outcomes. Furthermore, a study of patients with chronic kidney disease52 has shown how deprivation can contribute to the burden of renal diseases.…”

Section: Discussionmentioning

confidence: 99%

Estimating the prevalence of diagnosed Alzheimer disease in England across deprivation groups using electronic health records: a clinical practice research datalink study

Leahy,

Simpson,

Sammon

et al. 2023

BMJ Open

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ObjectiveEstimate the prevalence of diagnosed Alzheimer’s disease (AD) and early Alzheimer’s disease (eAD) overall and stratified by age, sex and deprivation and combinations thereof in England on 1 January 2020.DesignCross-sectional.SettingPrimary care electronic health record data, the Clinical Practice Research database linked with secondary care data, Hospital Episode Statistics (HES) and patient-level deprivation data, Index of Multiple Deprivation (IMD).Outcome measuresThe prevalence per 100 000 of the population and corresponding 95% CIs for both diagnosed AD and eAD overall and stratified by covariates. Sensitivity analyses were conducted to assess the sensitivity of the population definition and look-back period.ResultsThere were 448 797 patients identified in the Clinical Practice Research Datalink that satisfied the study inclusion criteria and were eligible for HES and IMD linkage. For the main analysis of AD and eAD, 379 763 patients are eligible for inclusion in the denominator. This resulted in an estimated prevalence of diagnosed AD of 378.39 (95% CI, 359.36 to 398.44) per 100 000 and eAD of 292.81 (95% CI, 276.12 to 310.52) per 100 000. Prevalence estimates across main and sensitivity analyses for the entire AD study population were found to vary widely with estimates ranging from 137.48 (95% CI, 127.05 to 148.76) to 796.55 (95% CI, 768.77 to 825.33). There was significant variation in prevalence of diagnosed eAD when assessing the sensitivity with the look-back periods, as low as 120.54 (95% CI, 110.80 to 131.14) per 100 000, and as high as 519.01 (95% CI, 496.64 to 542.37) per 100 000.ConclusionsThe study found relatively consistent patterns of prevalence across both AD and eAD populations. Generally, the prevalence of diagnosed AD increased with age and increased with deprivation for each age category. Women had a higher prevalence than men. More granular levels of stratification reduced patient numbers and increased the uncertainty of point prevalence estimates. Despite this, the study found a relationship between deprivation and prevalence of AD.

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Association between social deprivation and disease activity in rheumatoid arthritis: a systematic literature review

Cited by 25 publications

References 42 publications

Difficult-to-treat rheumatoid arthritis (D2T RA): clinical issues at early stages of disease

Difficult-to-treat rheumatoid arthritis (D2T RA): clinical issues at early stages of disease

Social deprivation and exclusion in Parkinson’s disease: a cross-sectional and longitudinal study

Estimating the prevalence of diagnosed Alzheimer disease in England across deprivation groups using electronic health records: a clinical practice research datalink study

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