rheumatoid arthritis<\/a> (RA). However, when compared with the general RA population in the U.S., some groups have reported graver cross-sectional disability and worse functional outcomes in Hispanics, highlighting the importance of determining the potentially unique clinical features of their RA course.<\/span><\/p>\nTo address this knowledge gap, George A. Karpouzas, MD, and colleagues from the Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute evaluated the change in disability over time and determinants of clinically meaningful change in functional disability in low-income Hispanic patients with established RA. The results were published in the February 2017 issue of Arthritis Care & Research<\/em>.<\/span><\/p>\nOne hundred and fifty-six Hispanic participants were selected from the extended Harbor-University of California at Los Angeles (UCLA) RA observational cohort. Most participants were immigrant Hispanic patients of low-socioeconomic status: 80% were uninsured and 20% had Medicaid coverage. Ninety percent declared Spanish was their preferred language. Participants were evaluated during three consecutive visits (baseline, six- and 12-month follow-ups) for disability, disease activity (Disease Activity Score in 28 joints [DAS28]), pain and depression. Serology results, radiographs, treatments and irreversible articular damage were also recorded.<\/span><\/p>\nThe Results
\n<\/strong><\/span><\/h3>\n\u201cWe confirmed that disease activity, depression and pain were modifiable parameters with sizeable, independent and additive contributions to HAQ DI [Health Assessment Questionnaire disability index] variance,\u201d write the authors. Overall, time was a factor in the improvement of disability, with 51% of patients who had HAQ DI \u22651 at baseline showing significant improvement.<\/span><\/p>\nAt baseline, 71% of participants had significant disability (HAQ DI >1) and 34% were depressed. However, the disability score improved significantly (P<\/em>=0.032). At the third visit, 65 patients (42%) had clinically meaningful improvement in disability (DHAQ DI .0.22), 36 (23%) had deterioration, and 55 (35%) remained unchanged. Researchers also established that the absence of depression, less pain, lack of erosions and no biologic agent use at baseline all predicted the greatest improvement (P<\/em><0.001) in disability.<\/span><\/p>\nDespite the results, clinically meaningful improvement was not limited to patients with favorable profiles. The authors note, \u201cImprovement was rather contingent upon simultaneous, reciprocal, and synergistic recovery in DAS28 [Patient Health Questionnaire (PHQ)]-9 and pain, regardless of original severity and further facilitated by lack of erosions or of biologic agent use. Notably, isolated improvement in PHQ-9 greater than [minimum clinically important difference] was sufficient and able to independently yield significant disability improvement.\u201d<\/span><\/p>\nIn their discussion, the authors write, despite seeing a clinically relevant improvement in disability over time, \u201cOur results confirm the persistence of significant residual disability; 53% of patients exhibited HAQ DI \u22651 throughout the entire observation period.\u201d Many of the study participants entered the health care system with their disease well underway, commonly undiagnosed, and inconsistently or inadequately treated for years. Because the study observation period was short, \u201cwe are therefore uncertain how sustainable this improvement in disability might be over a longer time frame.\u201d<\/span><\/p>\nFor Hispanic patients with RA, \u201cimprovement over time, collectively or in isolation, and regardless of their original severity, may yield clinically measurable improvements in functional disability and reaffirms all of them as actionable items in a patient-centered treat-to-target approach,\u201d conclude the authors.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"En FOMAT, esta investigaci\u00f3n nos toca especialmente de cerca. Nuestros centros cl\u00ednicos del sur de California atienden a una amplia poblaci\u00f3n de pacientes hispanos, muchos de los cuales se enfrentan a las mismas barreras descritas en este estudio, como las dificultades ling\u00fc\u00edsticas, la falta de seguro m\u00e9dico y los retrasos en el diagn\u00f3stico\u2026.<\/p>","protected":false},"author":3,"featured_media":21724,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[968],"tags":[],"class_list":["post-7007","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blogs-updates"],"acf":[],"_links":{"self":[{"href":"https:\/\/fomatmedical.com\/es\/wp-json\/wp\/v2\/posts\/7007","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/fomatmedical.com\/es\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/fomatmedical.com\/es\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/fomatmedical.com\/es\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/fomatmedical.com\/es\/wp-json\/wp\/v2\/comments?post=7007"}],"version-history":[{"count":1,"href":"https:\/\/fomatmedical.com\/es\/wp-json\/wp\/v2\/posts\/7007\/revisions"}],"predecessor-version":[{"id":73131,"href":"https:\/\/fomatmedical.com\/es\/wp-json\/wp\/v2\/posts\/7007\/revisions\/73131"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/fomatmedical.com\/es\/wp-json\/wp\/v2\/media\/21724"}],"wp:attachment":[{"href":"https:\/\/fomatmedical.com\/es\/wp-json\/wp\/v2\/media?parent=7007"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/fomatmedical.com\/es\/wp-json\/wp\/v2\/categories?post=7007"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/fomatmedical.com\/es\/wp-json\/wp\/v2\/tags?post=7007"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}