Skip to main content

Advertisement

Log in

Extraarticular manifestations in Turkish patients with rheumatoid arthritis: impact of EAMs on the health-related quality of life in terms of disease activity, functional status, severity of pain, and social and emotional functioning

  • Original Article
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

The aim of our study was to investigate extraarticular manifestations (EAMs) in Turkish patients with rheumatoid arthritis (RA) and also assess the impact of EAMs on various health-related quality of life (HRQoL) domains, including physical, social, emotional, mental functioning, and bodily pain. A total of 150 patients were included in the study. EAMs were identified clinically. Pulmonary involvement was confirmed by using pulmonary function tests (PFT) and high-resolution computed tomography (HRCT), atlantoaxial subluxation by cervical spine X-rays. Peripheral neuropathy, rheumatoid nodules, and Sicca symptoms were picked up on clinical examination. Peripheral neuropathy was also confirmed by electroneurophysiologic studies. Patients were evaluated by Rheumatoid Arthritis Quality of Life (RAQoL), and Short form-36 (SF36). The quadrivariate Disease Activity Score- 28 (DAS28) was used for measuring disease activity. Functional status was evaluated by using the Stanford Health Assessment Questionnaire (HAQ). The severity of pain was documented by using 10-cm Visual Analog Scale-Pain (VAS-pain). EAMs were observed in 50 patients (33.3%). These were pulmonary involvement (28.7%), rheumatoid nodules (14.7%), Sicca Syndrome (8%), peripheral neuropathy (2.7%), and atlantoaxial subluxation (0.7%), respectively. It was not recorded any statistically significant difference in HAQ, DAS28, VAS-pain, and RAQoL scores between the patient groups with and without EAMs. Patients with EAMs scored significantly lower in physical functioning, role-physical, and role-emotional subgroups of SF36 (P < 0.01). Presence of EAMs is not directly associated with disease activity and functional status, but influences negatively HRQoL including physical and emotional functioning.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hochberg MC, Johnston SS, John AK (2008) The incidence, prevalence of extra-articular, systemic manifestations in a cohort of newly-diagnosed patients with rheumatoid arthritis between 1999 and 2006. Curr Med Res Opin 24(2):469–480

    Article  PubMed  Google Scholar 

  2. Marra CA, Woolcott JC, Kopec JA, Shojania K, Offer R, Brazier JE, Esdaile JM, Anis AH (2005) A comparison of generic, indirect utility measures (the HUI2, HUI3, SF-6D, and the EQ-5D) and disease-specific instruments (the RAQoL and the HAQ) in rheumatoid arthritis. Soc Sci Med 60(7):1571–1582

    Article  PubMed  Google Scholar 

  3. Lillegraven S, Kvien TK (2007) Measuring disability and quality of life in established rheumatoid arthritis. Best Pract Res Clin Rheumatol 21(5):827–840

    Article  PubMed  Google Scholar 

  4. Arnett FC, Edworthy SM, Block DA et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324

    Article  PubMed  CAS  Google Scholar 

  5. Prevoo MLL, van’t Hof MA, Kuper HH et al (1995) Modified disease activity scores that include twenty-eight-joint counts. Arthritis Rheum 38:44–48

    Article  PubMed  CAS  Google Scholar 

  6. Price DD, McGrath P, Buckingham B, Rafii A (1983) The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 17:45–56

    Article  PubMed  CAS  Google Scholar 

  7. Tugwell P, Idzerda L, Wells GA (2007) Generic quality of life assessment in rheumatoid arthritis. Am J Manag Care 13(9):224–236

    Google Scholar 

  8. Kutlay S, Kucukdeveci AA, Gonul DD, Tennant A (2003) Adaptation and validation of the Turkish version of the rheumatoid arthritis quality of life scale. Rheumatol Int 23:21–26

    PubMed  Google Scholar 

  9. Kucukdeveci AA, Sahin H, Ataman S, Griffiths B, Tennant A (2004) Issues in cross—cultural validity: example from the adaptation, reliability, and validity testing of a Turkish version of the Stanford Health Assessment Questionnaire. Arthritis Rheum 51:14–19

    Article  PubMed  Google Scholar 

  10. Bodur H, Ataman S, Akbulut L, Evcik D, Kavuncu V (2008) Characteristics and medical management of patients with rheumatoid arthritis and ankylosing spondylitis. Clin Rheumatol 27(9):1119–1125

    Article  PubMed  CAS  Google Scholar 

  11. Calguneri M, Ureten K, Akif Ozturk M, Onat AM, Ertenli I, Kiraz S, Akdogan A (2006) Extra-articular manifestations of rheumatoid arthritis: results of a University Hospital of 526 patients in Turkey. Clin Exp Rheumatol 24(3):305–308

    PubMed  CAS  Google Scholar 

  12. Cimmino MA, Salvarani C, Macchioni P, Montecucco C, Fossaluzza V (2000) Extra-articular manifestations in 587 Italian patients with rheumatoid arthritis. Rheumatol Int 19(6):213–217

    Article  PubMed  CAS  Google Scholar 

  13. Carmona L, Gonzales-Alvaro I, Balsa A, Angel Belmonte M, Tena X, Sanmarti R (2003) Rheumatoid arthritis in Spain: occurrence of extra-articular manifestations and estimates of disease severity. Ann Rheum Dis 62(9):897–900

    Article  PubMed  CAS  Google Scholar 

  14. Demir R, Bodur H, Tokoglu F, Olcay I, Ucan H (1999) High resolution computed tomography of the lungs in patients with rheumatoid arthritis. Rheumatol Int 19(1–2):19–22

    Article  PubMed  CAS  Google Scholar 

  15. Alexiou I, Germenis A, Koutroumpas A, Kontogianni A, Theodoridou K, Sakkas LI (2008) Anti-cyclic citrullinated peptide-2 (CCP2) autoantibodies and extra-articular manifestations in Greek patients with rheumatoid arthritis. Clin Rheumatol 27(4):511–513

    Article  PubMed  Google Scholar 

  16. Bedi GS, Gupta N, Handa R, Pal H, Pandey RM (2005) Quality of life in Indian patients with rheumatoid arthritis. Qual Life Res 14(8):1953–1958

    Article  PubMed  Google Scholar 

  17. Haroon N, Aggarwal A, Lawrence A, Agarwal V, Misra R (2007) Impact of rheumatoid arthritis on quality of life. Mod Rheumatol 17(4):290–295

    Article  PubMed  Google Scholar 

  18. Al-Ghamdi A, Attar SM (2009) Extra-articular manifestations of rheumatoid arthritis: a hospital-based study. Ann Saudi Med 29(3):189–193

    PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yeşim Garip.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Eser, F., Garip, Y. & Bodur, H. Extraarticular manifestations in Turkish patients with rheumatoid arthritis: impact of EAMs on the health-related quality of life in terms of disease activity, functional status, severity of pain, and social and emotional functioning. Rheumatol Int 32, 1521–1525 (2012). https://doi.org/10.1007/s00296-011-1822-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-011-1822-1

Keywords

Navigation