March 27, 2019
4 min read

Disease burden for RA, OA similar at first visit, greater in OA at 6 months

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Theodore Pincus

Although disease burden, as measured by health assessment questionnaires, is similar among patients with osteoarthritis and rheumatoid arthritis at the time of initial visit, those with osteoarthritis demonstrate greater burden scores 6 months later, according to data published in Arthritis & Rheumatology.

“OA traditionally has been regarded as a result of ‘wear and tear,’ with far fewer consequences to patients compared to RA,” Theodore Pincus, MD, of Rush University Medical Center, told Healio Rheumatology.

“That may be the case for some patients, and possibly for most patients in the past,” he noted. “At this time, however, OA [disease burden] appears as severe as RA at the first visit to a rheumatologist, according to scores on a multidimensional health assessment questionnaire (MDHAQ) including the RAPID3 composite within the MDHAQ to assess patient disease burden.”

Image of arthritic hand 
Although disease burden is similar among patients with OA and RA at the time of initial visit, those with OA demonstrate greater burden scores 6 months later, according to data.
Source: Adobe

To compare disease burden in individuals with OA and RA at initial visit and during 6 months of follow-up, Pincus and colleagues analyzed rheumatology patients at Rush University Medical Center, including 149 with OA and 203 with RA. All participants completed the MDHAQ at all visits.

The researchers compiled MDHAQ scores for physical function, pain and patient global assessment into RAPID3, as well as additional scales, and compared the information for patients with RA and OA at baseline and 6 months. In addition, patients with either condition were group based on whether they were self- or physician-referred, and whether those with RA had previously used disease-modifying antirheumatic drugs. These groups were compared using ttests and analysis of variance, adjusting for age, disease duration, BMI, education and ethnicity.

According to the researchers, mean RAPID3 scores were not significantly different between patients with OA and those with RA who were DMARDnaive, whether self or physicianreferred (P = .38). In addition, there were no significant difference in RAPID3 scores between patients with OA and those with RA who were DMARDnaive vs. those who had previously used DMARDs (P = .49). However, after 6months, RAPID3 scores improved substantially more among participants with RA compared with those with OA. The researchers reported similar findings for most selfreported measures, as well as in adjusted analyses.

“All health professionals, including primary care physicians, orthopedists, rheumatologists, physical therapists, occupational therapists, pharmacists and others must take symptoms of OA as seriously as symptoms of RA,” Pincus said. “A clear need exists to develop therapies to better prevent and manage the symptoms of OA.”


“The same MDHAQ is informative in all rheumatic diseases in which it has been studied to date, and can be used effectively to compare disease burden in different diseases,” he added. “These data were gathered without any grant support from completion of a MDHAQ by each patient at each visit in routine care data as an adjunct to clinical decisions in patient management. Similar approaches in any clinical setting can facilitate further recognition of disease burden in individual patients in clinical settings, in patient groups for clinical research, and to provide guidance for public health priorities.” – by Jason Laday

Disclosure: Pincus reports a copyright and trademark on MDHAQ and RAPID3, for which he receives royalties and license fees. Please see the study for all other relevant financial disclosures.