OBJECTIVES

The objective of this analysis is to characterize the association of depression with disease activity, pain and fatigue scores in a cohort of patients with rheumatoid arthristis (RA).

METHODS : The OM1 RA Registry (OM1, Boston, MA) follows more than 100,000 adult patients longitudinally with deep clinical data, including laboratory, symptom, patient-reported and disease activity information, during the years of 2013-2018. The OM1 Data Cloud collects, links and leverages additional structured and unstructured data from electronic medical records (EMR), claims and other sources in an ongoing and continuously updating manner. These linkages provide ongoing data from rheumatologists, primary care and other specialties, which is important in understanding the multi-systemic burden of the disease. For this cross-sectional analyses, patients with at least one RA disease activity score (DAS) were included and depression was defined by diagnosis codes. Functional Assessment of Chronic Illness Therapy fatigue score and multidimensional health questionnaires were used to assess patient pain and fatigue, as well as routine assessment of patient index data 3 (RAPID3) scores.

RESULTS : Overall, 94,588 patients had at least one DAS, 76.9% were women, median age was 64 years, 50.5% had initiated a bDMARD and 14% of patients met the definition for depression at some time during the observation period. Patients with depression were younger (62 years vs. 65), less likely to be in remission or have low DAS (9.4% vs. 16.5%) based on American College of Rheumatology criteria, and had higher fatigue (6 vs. 4), pain (6 vs. 4), and RAPID3 scores (6.0 vs. 5.2). P < 0.05 for all comparisons.

CONCLUSIONS : Depression was associated with higher RA DAS and lower quality of life in multiple domains. Full assessment of comorbid depression should be considered during the evaluation of patient scores and treatment choice.