Ali Saadia Sasha, Demetriou Christiana, Parodis Ioannis, Tan Ai Lyn, Edgar Gracia-Ramos Abraham, Joshi Mrudula, Caballero-Uribe Carlo V, Saha Sreoshy, Lilleker James B, Nune Arvind, Pauling John D, Wincup Chris, Jagtap Kshitij, Dey Dzifa, Milchert Marcin, Distler Oliver, Chinoy Hector, Agarwal Vikas, Gupta Latika, Nikiphorou Elena
Rheumatology Department, King's College Hospital, London, UK.
University of Nicosia Medical School, Epidemiology and Public Health, Nicosia, Cyprus.
Rheumatol Adv Pract. 2024 Dec 30;9(1):rkae154. doi: 10.1093/rap/rkae154. eCollection 2025.
Physical function in RA is largely influenced by multiple clinical factors, however, there is a growing body of evidence that psychological state and other comorbidities also play an essential role. Using data obtained in the COVID-19 Vaccination in Autoimmune Diseases study, an international self-reported e-survey, we aimed to explore the predictive ability of sociodemographic and clinical variables on Patient-Reported Outcomes Measurement Information System Physical Function Short Form 10a (PROMIS PF-10a) in RA and to investigate variation in disease activity and functional outcomes based on country-level socio-economic parameters.
Patient demographics, disease characteristics including current symptom status, functional status and treatment variables, as well as income level of the country of residence, were extracted from survey responses. PROMIS PF-10a scores were compared across country income levels. The influence of extracted variables on reversed PROMIS PF-10a scores were investigated using negative binomial univariable- and multivariable regression.
A total of 1342 RA patients were included in this analysis. In the optimised parsimonious predictive model for reversed PROMIS PF-10a, older age, female gender, disease duration, fatigue and pain levels were independently associated with worse physical function, whereas Asian ethnicity, higher overall physical health ratings, ability to carry out everyday activities and residing in a country with an upper-middle or high-income level were independently associated with better physical function.
Our study highlights that clinical factors remain strong predictors of physical function in RA, irrespective of individual and country-level socio-economic differences. Interestingly, high country-level income was associated with better physical function, irrespective of individual sociodemographic and clinical factors.
类风湿关节炎（RA）的身体功能在很大程度上受多种临床因素影响，然而，越来越多的证据表明心理状态和其他合并症也起着至关重要的作用。利用在自身免疫性疾病COVID-19疫苗接种研究（一项国际自我报告的电子调查）中获得的数据，我们旨在探讨社会人口统计学和临床变量对RA患者报告结局测量信息系统身体功能简表10a（PROMIS PF-10a）的预测能力，并根据国家层面的社会经济参数研究疾病活动度和功能结局的差异。
从调查回复中提取患者人口统计学信息、疾病特征（包括当前症状状态、功能状态和治疗变量）以及居住国家的收入水平。比较不同国家收入水平的PROMIS PF-10a得分。使用负二项单变量和多变量回归研究提取变量对反向PROMIS PF-10a得分的影响。
本分析共纳入1342例RA患者。在反向PROMIS PF-10a的优化简约预测模型中，年龄较大、女性、疾病持续时间、疲劳和疼痛程度与较差的身体功能独立相关，而亚洲种族、较高的总体身体健康评分、进行日常活动的能力以及居住在中高收入或高收入国家与较好的身体功能独立相关。
我们的研究强调，无论个体和国家层面的社会经济差异如何，临床因素仍然是RA身体功能的强有力预测因素。有趣的是，无论个体社会人口统计学和临床因素如何，国家层面的高收入与较好的身体功能相关。
