Investigation of the Risk of Frailty Progression Based on 5-Year Data in Patients With Rheumatoid Arthritis: A Multicenter Observational Study (T-FLAG)

IF 2.4 4区医学 Q2 RHEUMATOLOGY

International Journal of Rheumatic Diseases Pub Date : 2025-04-07 DOI:10.1111/1756-185X.70162

Yoshifumi Ohashi, Mochihito Suzuki, Yasumori Sobue, Kenya Terabe, Shuji Asai, Shiro Imagama, Nobunori Takahashi

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引用次数: 0

Abstract

Objectives

To examine risk factors for non-frailty rheumatoid arthritis (RA) patients progressing to frailty.

Methods

A total of 304 RA patients with records for frailty assessment based on the Japanese Cardiovascular Health Study (J-CHS) criteria from 2020 to 2024 were included. Patients classified as non-frail (J-CHS scores 0–3) in 2020 were followed annually, and those who did and did not progress to frailty were categorized into the frailty progression (n = 100) and non-frailty progression (n = 204) groups, respectively. Risk factors for frailty progression were analyzed using the Cox proportional hazards model. Changes in DAS28-ESR and HAQ-DI between baseline and frailty progression were compared using a paired t-test.

Results

Compared to the non-frailty progression group, the frailty progression group was older (62.9 vs. 68.5 years) and had a longer duration of disease (9.1 vs. 14.2 years), lower methotrexate (MTX) use (74.4% vs. 56.1%), higher mean DAS28-ESR (2.40 vs. 2.77), and higher HAQ-DI (0.17 vs. 0.45). Both groups had high biological/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) use rates (34.3% vs. 42.0%). Risk factors for frailty events included age ≥ 65 years (HR 1.86), duration of disease ≥ 10 years (HR 1.64), DAS28-ESR < 2.6 (HR 0.64), HAQ-DI ≤ 0.5 (HR 0.45), and MTX use (HR 0.63). DAS28-ESR remained at a low disease activity level (baseline vs. frailty progression: 2.77 vs. 2.90), whereas HAQ-DI worsened at frailty progression compared to baseline (0.45 vs. 0.66).

Conclusions

Optimizing MTX use and achieving DAS/HAQ remission are crucial for preventing frailty. Non-medication-based approaches are also essential.

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来源期刊

International Journal of Rheumatic Diseases RHEUMATOLOGY-

CiteScore

3.70

自引率

4.00%

发文量

362

审稿时长

1 months

期刊介绍： The International Journal of Rheumatic Diseases (formerly APLAR Journal of Rheumatology) is the official journal of the Asia Pacific League of Associations for Rheumatology. The Journal accepts original articles on clinical or experimental research pertinent to the rheumatic diseases, work on connective tissue diseases and other immune and allergic disorders. The acceptance criteria for all papers are the quality and originality of the research and its significance to our readership. Except where otherwise stated, manuscripts are peer reviewed by two anonymous reviewers and the Editor.