Almost all patients in the study were initially treated with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), and 75% were on methotrexate. Not using methotrexate increased the likelihood of lack of remission by 28% in women and by 45% in men.
“These results highlight the need to support physicians and empower patients to take advantage of the impact lifestyle changes can have on disease progression,” Dr. Johannes W. Bijlsma, EULAR President, writes in a press release. “We consider it essential that recommendations reach all audiences—from rheumatologists, patients and patient organisations to healthcare professionals—in order to support all in understanding how to best manage the disease.”
“A great deal of care and attention is placed on getting people started on effective treatments right away. Our data suggest that health behaviors also play an important role in determining how well treatment works, and that different health behaviors contribute to suboptimal management in men and women,” Dr. Bartlett says.
Dr. Bartlett notes that RA treatments are highly effective, but not in everyone.
“Many are very expensive, too,” she says. “It is important to not only understand who is at greater risk of not responding to treatment and what we might be able to do to improve outcomes. Lifestyle plays a very important role in improving disease control and RA outcomes. Also, RA affects three times as many women as men, so it’s important to know that factors associated with suboptimal response to treatment differ in men and women.”
“We don’t know whether, if women lose weight or men stop smoking, this will improve the likelihood of quickly getting their RA under good control,” Dr. Bartlett adds. “These behaviors will definitely improve health, so there is no downside to adopting a healthier lifestyle. But whether this actually helps RA medications work more effectively has yet to be studied.”
- Bartlett S, Schieir O, Valois M, et al. Who is not reaching remission in early ra and why? Predictors for persistent disease activity in the first year differ in men and women and are related to lifestyle and treatment (OP0106). Ann Rheum Dis. 2018 Jun;77:103–104