ARTHRITIS WATCH

Published Online: Tuesday, May 1, 2007

RA Patients Have Poorer Self-image

Patients with rheumatoid arthritis (RA) can experience physical deformities, especially of the hands and feet. A study that examined the relationship between physical appearance concerns and psychological distress in RA patients shows that women with RA have poorer body self-images than women without the disease. The results of the study were published in the March 2007 issue of Arthritis Care & Research.

The study, which took place at the University of Sydney in New South Wales, Australia, included 157 patients with lupus, newly diagnosed RA, or chronic RA. The patients with RA completed a different set of questionnaires regarding their health than those with lupus because of the disparities between the conditions. The researchers looked at disability, health-related quality of life, psychological distress, and coping strategies. The RA patients also underwent joint assessments. The results showed that 30% of the patients with chronic RA and 34% with newly diagnosed RA reported that they felt unattractive because of their disease. They found that both appearance and physical disability are predictive of depression in these patients. The researchers think that, because depression is linked to future disability, targeting appearance concerns of RA patients may improve their mood, which could lead to better health outcomes.

Heavy Patients Suffer More Surgery Complications

A study from the Geneva University Hospital in Switzerland showed that obese patients are more likely to have a higher rate of total hip replacements due to a greater incidence of hip osteoarthritis. The study evaluated the effects of obesity on complications and outcomes following total hip replacements and learned whether the results differed between obese women and men. The findings were published in the March 2007 issue of Arthritis Care & Research.

The researchers looked at information on patients who underwent total hip replacements between March 1996 and July 2005 at the hospital. Of the 2495 surgeries, 589 were performed on obese patients, comprised of more men than women. The researchers evaluated the incidence of infection, dislocation, and revision (having to redo the surgery), as well as quality of life, satisfaction, and general health 5 years after the replacement.

The results showed that obesity was associated with a substantially higher risk for infection in women, led to more dislocation in women, and resulted in more revisions due to septic loosening caused by infection. After 5 years, obese women reported moderately lower functional outcomes and slightly less satisfaction, mostly due to a higher rate of complications.

Evaluating the Cost of JIA

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease that afflicts children, yet little is known about its impact on the economy. A study conducted by the McGill University Health Centre in Montreal, Quebec, Canada, examined the direct medical costs of caring for children with JIA and found those costs to be substantial.

Researchers looked at 155 children with JIA and 181 controls from 2 hospitals in Montreal and Vancouver. The parents of the participants were asked to fill out a questionnaire about medication use and health service access during the prior 3 months, without specifying any exact disease. The parents were also queried about time lost from work and how many days the children missed school. The researchers noted that parents of children with JIA had higher costs related to specialists, health care professionals, and diagnostic tests, and the difference in annual direct medical costs for the JIA group was $1686 more than for the control group.

The researchers stated, "Ongoing active inflammation and the consequent joint damage have a significant impact on the ability of an individual to be a productive member of society,"and that "decisions regarding access to therapies should be considered in terms of overall cost-benefit ratios."The findings were published in the February 2007 issue of Arthritis Care & Research.

Anticipating RA Can Help Postpone Pain

Researchers at the Leiden University Medical Center in the Netherlands believe that they may have found a new way of predicting whether patients with arthritic symptoms will actually progress to rheumatoid arthritis (RA). The best strategy against crippling joint damage from RA is very early, aggressive medicinal treatment. The drugs tend to have undesirable side effects, however; the researchers' goal is to determine which patients will actually need the therapy in order to spare those who do not from the adverse effects.

The researchers looked at 570 patients at the Leiden Early Arthritis Clinic with undifferentiated arthritis, 177 of whom progressed to RA within a year. The researchers were able to identify 9 variables and 3 laboratory tests by using a combination of questionnaires, physical exams, and blood samples. Using a 14-point predictive score based on their assessments, with 0 being the lowest likelihood of progression to RA, the researchers found that none of the patients who scored 3 or less developed RA, while all those who scored 11 or higher did. The findings were published in the February 2007 issue of Arthritis & Rheumatism.




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