Arthritis Watch

Pharmacy Times, Volume 0,0

Is Depression Associated with RA?

Disability and a recent diagnosis of rheumatoid arthritis (RA)are linked with a greater risk for depression, according tostudy findings recently presented at the American College ofRheumatology Annual Scientific Meeting.

Study results indicated that patients with RA who aredepressed have worse outcomes than patients with RA whoare not depressed. Earlier studies regarding RA and depressionincluded a primarily Caucasian population.

To eliminate this bias, researchers from the University ofCalifornia, San Francisco, created a study to evaluate predictorsof depression in patients from a multiethnic group ofindividuals with RA at an urban hospital.

Of the 210 patients enrolled in the study, 39% had scoreson the Patient Health Questionnaire-9 that indicated at leastmoderate depression. Patient, disease, and treatment-relatedinformation were collected to see if any of these factorswere associated with depression.

The study results found that race/ethnicity, disease activity,and medications were not associated with depression. Thefactors related to depression are shorter disease durationand increased disability as scored on the Health AssessmentQuestionnaire.

Working Splints Reduce Wrist Arthritis Pain

Patients with wrist arthritis benefit from working splints,according to Dutch researchers, whose study was publishedin the December 2008 issue of Arthritis & Rheumatism.

For the study, the researchers assessed the effectiveness ofwrist splinting that allowed enough movement to perform regularactivities in 33 patients with wrist arthritis. Of the patients, 17were assigned to use a prefabricated wrist working splint and 16acted as the control group. The patients in the splinting groupwere told to use the splint as much as possible during the day.

After 4 weeks, the investigators found a 32% decrease inpain scores registered on a visual analog scale in the treatmentgroup, whereas the scores in the control group increased by17%. Furthermore, the average grip strength scores rose by 5%in the splinting group and dropped by 8% in the control group.The researchers noted, however, that these and other differencesin functional ability were not major, statistically speaking.

Teens with Arthritis Need More Counseling

Results of a study, reported in the January 2009 issue ofArthritis Care & Research, showed that children with arthritisneed more assistance and information during their teen yearsto make sure they receive proper health care as adults.

The researchers looked at data from the 2005-2006 NationalSurvey of Children with Special Health Care Needs. Fourquestions examined the extent to which providers discussedhealth care transition issues, including transfer of care toadult providers, health care needs of adults, acquiring healthinsurance, and encouraging self-care responsibility.

Whereas 75% of adolescents with arthritis are beingencouraged to assume self-care responsibilities, only about20% of adolescents with arthritis were given counseling onissues such as obtaining health insurance after coming of age,study results showed.

The findings mirrored similar national studies of youngpeople with any special health care needs. “Health care transitionis a complex set of tasks that are embedded within acomplex developmental period and a complex health caresystem,” the researchers wrote.

Abnormal ECG Detected in PsA Patients

The findings from a new study advise that patients with psoriaticarthritis (PsA) may have “subtle” cardiac conduction disturbances.The researchers noted, however, that it has not yet beendetermined if these irregularities lead to serious heart disease.

PsA is a form of rheumatoid arthritis accompanied by psoriasis.In the study, the researchers compared the electrocardiogram(ECG) scans of 92 patients with PsA with 92 controlpatients, individually matched for age and sex, who did nothave the condition.

“The major finding of our study,” reported the researchersin the Journal of Rheumatology (December 2008), “is astatistically significantly longer PR interval in the patients withPsA, compared with individuals without psoriasis or arthritis.”The lengthening of the PR interval is a sign of abnormal heartrhythm. The average PR interval was 8.3 milliseconds, 5.5%longer in the PsA patients, compared with the controls.

“Although the clinical relevance of this finding is questionablesince the absolute difference was small, the importanceof the observation is the implication of atrioventricular nodeinvolvement in the psoriatic arthritis systemic diseases,” notedthe researchers.

The researchers concluded that a larger study with a follow-upperiod is necessary to further investigate these conduction abnormalitiesand to see if they are related to cardiovascular disease.

F A S T F A C T: One in 5 (21%) adults in the United States report having doctor-diagnosed arthritis.