Quality of Life Less Impacted by Gout than Other Inflammatory Joint Diseases

Mats Dehlin, MD

Data from a cross-sectional survey of more than 2800 patients with inflammatory joint diseases provides new insight into the impact of various joint disorders on health-related quality of life.

A survey of patients with gout, psoriatic arthritis (PsA), rheumatoid arthritis (RA), and ankylosing spondylitis using the RAND 36-item health survey, results of the study demonstrate each disease had a substantial impact on health-related quality of life, but patients with gout reported better physical component summary scores than their counterparts with other inflammatory joint diseases.¹

“We found that health-related quality of life was more impaired in physical domains than in mental domains, across all inflammatory joint diseases overall and stratified by sex,” wrote investigators.¹ “Furthermore, patients with gout reported better scores for health-related quality of life, Health Assessment Questionnaire (HAQ), and numeric rating scales (NRS) global health, pain, and fatigue, compared with the other inflammatory joint diseases both with and without age matching, whereas health-related quality of life, HAQ, and NRS scores for global health, pain, and fatigue were more similar across PsA and ankylosing spondylitis, although RA patients had slightly worse scores compared with PsA and ankylosing spondylitis.”

Although the impact of rheumatic disease on quality of life well-documented, investigators of the current study purport no studies have been conducted comparing health-related quality of life of the 4 aforementioned diseases in the same setting. With this in mind, a team of investigators from the University of Gothenburg led by Mats Dehlin, MD, designed the current study to compare health-related quality of life using questionnaire data from patients receiving care at rheumatology and primary care centers in Western Sweden from January 2015-February 2017. Questionnaires were distributed to 5130 individuals and returned by 2896. From this 2896 patient cohort, investigators obtained data related to 868 patients with gout, 699 patients with PsA, 742 patients with RA, and 587 patients with ankylosing spondylitis.¹

The questionnaires distributed to patients included questions on demographics, comorbidities, medication use, and health-related quality of life. Health-related quality of life was assessed using the RNAD 36-item questionnaire, which contains 36 items and is divided in 8 domains. In addition to an overall summary score, the questionnaire responses are also used to physical and mental component summary (PCS and MCS) scores. Investigators pointed out a score below 50 for PCS or MCS scores is indicative of it being below the normative value for the general population

Results of the investigators’ analyses indicated the PCS scores (range, 39.7-41.2) of patients with any of the inflammatory joint diseases were more impacted than the MCS scores (range, 43.7-48.9), with this observation consistent across all diseases. Further analysis demonstrated patients with gout reported better PCS than patients with PsA, RA, and ankylosing spondylitis, with patients with these 3 diseases reporting similar scores in age-matched analysis.¹

Investigators pointed out MCS scores were close to normative values for the general population and results indicated scores were similar across the 4 inflammatory joint diseases examined in the study. Additionally, investigators called attention to differences in scores seen for women compared to their male counterparts, with women reporting worse PCS for all 4 inflammatory joint diseases included in the study (range, 34.5–37.4 vs 37.5–42.5) as well as worse MCS for both PsA (44.0 vs 46.8) and RA (46.1 vs 48.7).¹

“These overall observed differences in health-related quality of life between inflammatory joint diseases and sexes are important to be aware of when evaluating changes over time, setting treatment goals, and evaluating the effect of therapy in the inflammatory joint diseases,” investigators concluded.¹

References

1. Landgren AJ, Klingberg E, Jacobsson LTH, Bergsten U, Dehlin M. Health-related quality of life in gout, psoriatic arthritis, rheumatoid arthritis and ankylosing spondylitis, results from a cross-sectional survey in western Sweden. Scandinavian Journal of Rheumatology. 2023:1-13. doi:10.1080/03009742.2022.2157962