The findings suggest that more patients who experience flare-ups also have depression
Overall, the findings of the study indicated that more patients who experienced flare-ups were considered to have depression, with a median score on the SF-36 mental health subscale of 56 or lower. Even after adjustment in factors such as age, gender, weight, and baseline DAS28, only the SF-36 mental health subscale remained quite high. The median score on the Health Assessment Questionnaire (HAQ) was 0.6 and over 66% of patients had HAQ scores over 1, thereby indicating moderate to severe disability.
An important part of the research study was the definition of a flare-up, which required the presence of at least one swollen joint and an impartial feature; whereas other studies generally relied on the presence of tender joints and global assessment scores, which can be affected by changes in mood and other stressors. “The captured flare events in the OPTIRA study are more likely to represent a genuine inflammatory disease flare and less likely influenced by low mood or depression,” stated the researchers. They concluded that before making any attempts to taper with an RA patient’s medication dose or intensity of treatment, the patient’s mental health, along with their functional status, should be assessed.