Early RA patients initiating therapy need to stay active, study says

Most patients with early rheumatoid arthritis (RA) either are sedentary even prior to initiation of methotrexate (MTX) or stop performing physical activity (PA) over the first year of treatment, a study reports.

The study used data from the Rheumatoid Arthritis Medication Study (RAMS) and included 1,468 participants (median age, 60 years; 65.2 percent female) with early RA starting MTX. Participants reported demographics and completed questionnaires at baseline, 6 and 12 months, including reporting the number of days per week they performed ≥20 min of PA.

On average, participants were overweight (median body mass index, 27.2 kg/m²) and had moderate disease activity (median DAS28, 4.2). Furthermore, the population had moderate levels of disability, pain, and fatigue.

At baseline, 408 (27.8 percent) participants reported being sedentary, 518 (35.3 percent) had low PA levels (1–3 days per week), and 542 (36.9 percent) reported high PA levels (4–7 days per week). The majority of them (80 percent) maintained some PA or started doing PA between assessments (baseline to 6 months, 79.3 percent; 6 to 12 months, 80.7 percent).

Meanwhile, PA levels declined in 24.1 percent (175/725) of the participants who were already active at baseline. Of those still performing PA at 6 months, 22.6 percent (137/606) reduced their PA by 12 months, and 10.2 percent (62/606) stopped PA completely.

Factors significantly associated with PA cessation were baseline smoking, higher disability, and greater socioeconomic deprivation.

The findings indicate that a significant proportion of patients may benefit from interventions to keep them physically active. Public health strategies aimed at maintaining or promoting PA in RA need to take socioeconomic barriers into consideration when designing and delivering interventions.