Health-related quality of life (HRQoL) loss associated with self-perceived anxiety/depression in seropositive rheumatoid arthritis.

Objective: To analyze the HRQoL loss associated with self-perceived anxiety/depression in patients with seropositive rheumatoid arthritis (RA).

Method: This secondary data analysis is based on a registry-based retrospective follow-up study of patients with seropositive RA treated between August 2014 and January 2023 in ARTMEDICA, Colombia. HRQoL loss and self-perceived anxiety/depression were defined as outcomes. Disease activity (DAS-28) and other patient data were also gathered. Statistical analyses were performed using the ordinal logistic and generalized linear regression models.

Results: A total of 3579 patients with a mean follow-up of 2.9 (SD 2.4) years, 85.6% women with a median age at diagnosis of 48.1 (IQR 37.8-57.5) years, and a median of 6.5 (IQR 1.9-14.7) years living with RA were included. At program admission, the median DAS-28 score was 2.8 (IQR 2.1-4.2), and 6.6% of patients reported extreme anxiety/depression. The average HRQoL loss was 3.4 months per year lived with seropositive AR. Among patients with no pain or discomfort, moderate and extreme anxiety/depression were associated with mean HRQoL losses of 2.2 (95% CI - 2.3 to - 2.2) and 4.1 (95% CI - 4.3 to - 3.8) months. In patients with extreme pain/discomfort, these estimations were 0.8 (95% CI - 0.9 to - 0.7) and 1.9 (95% CI - 2.1 to - 1.7) months, respectively.

Conclusion: Our study adds to the available body of evidence by clarifying the differential impact of anxiety/depression on HRQoL, depending on the severity of pain. These findings highlight the importance of strengthening mental health care and psychological well-being interventions for patients with RA, regardless of pain or disease activity. Key Points • The average HRQoL loss was 3.4 months per year lived with seropositive AR. • Pain/discomfort rather than disease activity explained the severity of anxiety/depression as well as its associated HRQoL loss. • For patients with extreme pain/discomfort and anxiety/depression, the average HRQoL loss was 8.1 months per year lived with the disease compared to 0.4 months for patients without those impacts.