Residual symptoms and disease burden among patients with rheumatoid arthritis in remission or low disease activity: a systematic literature review

Ishida, Masato; Kuroiwa, Yuki; Yoshida, Emiko; Sato, Masayo; Krupa, Dominika; Henry, Nathaniel; Ikeda, Kei; Kaneko, Yuko

doi:10.1080/14397595.2017.1416940

Cited by 67 publications

(57 citation statements)

References 53 publications

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“…In rheumatoid arthritis (RA) patients, it had been shown that pain can persist even with the achievement of clinical targets, and that pain was also the most common residual symptom associated with RA remission or low disease activity. 4 In this review, we will discuss the potential of using cannabis and cannabinoids in the treatment of rheumatic disease, based on the literature existing on this issue.…”

Section: Introductionmentioning

confidence: 99%

Cannabis and Cannabinoids in the Treatment of Rheumatic Diseases

Gonen¹,

Amital²

2020

Rambam Maimonides Med J

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Section: Introductionmentioning

confidence: 99%

Cannabis and Cannabinoids in the Treatment of Rheumatic Diseases

Gonen¹,

Amital²

2020

Rambam Maimonides Med J

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“…Advances in treat-to-target strategies and targeted therapies have so far not ameliorated this problem as many RA patients report persistent fatigue despite attainment of clinical remission on biologic therapies [11,12]. Investigation of longitudinal data from the Early RA Network (ERAN) and Early RA Study (ERAS) in the United Kingdom for secular trends in disease trajectories for patients diagnosed in 1990, 2002, or 2010 have shown that while the initial 5-year course for inflammatory disease activity has improved over the decades, improvements in fatigue in early RA have been much smaller in magnitude and not statistically significant [13,14].…”

Section: Introductionmentioning

confidence: 99%

Multimorbidity and Fatigue in Rheumatoid Arthritis: A Cross-Sectional Study of a Population-Based Cohort

et al. 2020

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Introduction: The objective was to evaluate the relationships between multimorbidity and overall fatigue as well as fatigue subdomains in patients with rheumatoid arthritis (RA). Methods: A cross-sectional study of a population-based cohort of patients with RA was performed. Fatigue was assessed using the Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire (BRAF-MDQ). Patients' medical records were reviewed for 25 chronic comorbidities prior to the BRAF-MDQ. Linear and logistic regression models were used to estimate the differences in BRAF-MDQ total and subdomain (physical, living, cognitive, and emotional) scores associated with multimorbidity, adjusting for age, sex, disease duration, obesity, smoking, C-reactive protein, and RA autoantibodies. Higher BRAF-MDQ scores indicate greater fatigue severity. Results: The cohort included 192 patients, median age 62 years, and median RA duration 13 years. Multimorbidity was common with 93 (48%) having C 2 comorbidities, and 27 (14%) having C 4 comorbidities. The median BRAF-MDQ total score was 9 (interquartile range 3-18), with higher scores indicating greater fatigue. Patients with C 4 comorbidities had higher total BRAF-MDQ scores (median 16.5, interquartile range: 6.8-24.8) than patients with \ 4 comorbidities (7.5, 2.8-16.0; p = 0.014). Each additional comorbidity was associated with a 2.33 (95% confidence interval [CI] 1.10-3.56) unit increase in total BRAF-MDQ score (p \ 0.001), and the presence of C 4 comorbidities was associated with a 9.33 (95% CI 3.92-14.7) unit increase in total BRAF-MDQ score. Multimorbidity was significantly associated with all four fatigue subdomains in adjusted models. Conclusions: Multimorbidity is associated with increased fatigue in patients with RA. The findings suggest that interventions targeting multimorbidity could help alleviate treatmentrefractory fatigue in patients with RA and other rheumatic diseases.

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“…Four key examples are [1] pain, [2] depression and anxiety, [3] fatigue, and [4] muscle loss. Although controlling disease activity and achieving remission benefits patients it usually fails to normalise HRQoL [5, 7] and ameliorate pain [8] and fatigue [9, 10]. This is particularly true of those individuals with established disease, with two independent studies showing that short-form 36 (SF-36) health profiles – measuring health across 8 domains, each of which is scored from 0 to 100, with higher scores representing better health – are worse in patients with established RA in remission, compared with the normal general population (Fig.…”

Section: Introductionmentioning

confidence: 99%

The extra-articular impacts of rheumatoid arthritis: moving towards holistic care

et al. 2018

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Although treat-to-target has revolutionised the outcomes of patients with rheumatoid arthritis (RA) there is emerging evidence that attaining the target of remission is insufficient to normalise patients’ quality of life, and ameliorate the extra-articular impacts of RA. RA has a broad range of effects on patient’s lives, with four key “extra-articular” impacts being pain, depression and anxiety, fatigue and rheumatoid cachexia. All of these are seen frequently; for example, studies have reported that 1 in 4 patients with RA have high-levels of fatigue. Commonly used drug treatments (including simple analgesics, non-steroidal anti-inflammatory drugs and anti-depressants) have, at most, only modest benefits and often cause adverse events. Psychological strategies and dynamic and aerobic exercise all reduce issues like pain and fatigue, although their effects are also only modest. The aetiologies of these extra-articular impacts are multifactorial, but share overlapping components. Consequently, patients are likely to benefit from management strategies that extend beyond the assessment and treatment of synovitis, and incorporate more broad-based, or “holistic”, assessments of the extra-articular impacts of RA and their management, including non-pharmacological approaches. Innovative digital technologies (including tablet and smartphone “apps” that directly interface with hospital systems) are increasingly available that can directly capture patient-reported outcomes during and between clinic visits, and include them within electronic patient records. These are likely to play an important future role in delivering such approaches.

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Residual symptoms and disease burden among patients with rheumatoid arthritis in remission or low disease activity: a systematic literature review

Cited by 67 publications

References 53 publications

Cannabis and Cannabinoids in the Treatment of Rheumatic Diseases

Cannabis and Cannabinoids in the Treatment of Rheumatic Diseases

Multimorbidity and Fatigue in Rheumatoid Arthritis: A Cross-Sectional Study of a Population-Based Cohort

The extra-articular impacts of rheumatoid arthritis: moving towards holistic care

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