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    RA Patients See Big Boost in Quality of Life

    Dutch study found substantial drops in anxiety, depression and disability over 2 decades


    The observed trend: a dramatic two-decade drop in physical disabilities. The researchers also saw a decline in the incidence of anxiety and depression.

    For example, roughly one-quarter of patients diagnosed with rheumatoid arthritis in 1990 could expect to experience anxiety or depression after four years of treatment, compared with 12 percent to 14 percent of patients diagnosed today.

    While 53 percent of those diagnosed at the study's launch struggled with some measure of physical disability after four years of therapy, that figure dropped to 31 percent among new patients, the findings showed.

    Why? The team suggested that at least some of the quality-of-life boost seen among rheumatoid arthritis patients could be attributed to an overall plummet in disease activity -- and ultimately physical disabilities -- during the study period. This, they said, was a result of overall improvements in treatment strategies.

    But investigators also pointed out that while overall quality of life has gotten markedly better over the years, patient psychological "distress" has not dissipated as much as the onset of physical disabilities. And this, they warned, argues against drawing any clear cause-and-effect conclusions based on the current analysis.

    That said, "pharmacological [drug] treatment has improved a lot," Overman noted. "[And] treatment has become more intense. To keep inflammation and disease progression to a minimum, patients start medication as soon as possible, are monitored more frequently and medications are combined for optimal efficacy. Furthermore, effective new anti-inflammatory drugs have become available, such as the biologic agents."

    She added that non-medication treatments -- including exercise therapy and a form of counseling known as cognitive behavioral therapy -- have also been shown to help.

    The bottom line, Overman said, is: "Today, [rheumatoid arthritis] patients have a better opportunity of living a valued life than patients diagnosed with this autoimmune disease two decades ago."

    Dr. John Hardin -- vice president for research at the Arthritis Foundation, and a professor of medicine at the Albert Einstein College of Medicine in New York City -- wholeheartedly agreed.

    "Today we have a whole new series of drugs that have changed the face of the disease," he said. "All very good drugs. So the challenge now is to find the right drug for the right patient."

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