Predictors of functional impairment and pain in erosive osteoarthritis of the interphalangeal joints: Comparison with controlled inflammatory arthritis
Arthritis & Rheumatism, 04/24/2012
Wittoek R et al. – Among patients referred to a rheumatology clinic, patients with erosive osteoarthritis (EOA) showed more functional impairment and significantly more pain compared to patients with controlled inflammatory arthritis affecting the hands. This highlights the significant clinical burden of EOA and warrants the need for new treatment strategies.Methods
- A cross–sectional study including 270 patients with osteoarthritis (OA) of the hands, referred to the rheumatology clinics, was performed.
- An group of inflammatory arthritis patients (rheumatoid arthritis or psoriatic arthritis) with low disease activity score (DAS28 < 3.2) (n = 79) was examined.
- Levels of functional impairment (measured by FIHOA and AUSCAN) and pain were compared between the groups.
- Predictors of functional impairment in EOA were evaluated by Generalised Linear Models (GLM).
- Of 270 patients with hand OA, 167 (61.9%) were classified as EOA.
- Despite more intake of analgesics (almost 60%), patients with EOA showed worse functional outcome and pain scores than patients with controlled inflammatory arthritis and non–erosive OA.
- Pain scores remained significantly higher in EOA after correction for potential confounders.
- FIHOA and AUSCAN function scores showed a trend towards more disability in EOA.
- In EOA, female gender and number of destructive joints were the largest predictors of functional impairment.
- CMC joints being affected did not influence functional status in EOA.