Spondyloarthritis & psoriatic arthritis
The effect of anti-inflammatory treatment on depressive symptoms in spondyloarthritis: does the type of drug matter?
Main finding · Change in HADS-D from baseline (multivariable regression without disease activity measures)Result — go to the resultβ −1.27 95% CI −2.23 to −0.32Authors' conclusion
Treatment of active SpA also improves depressive symptoms. Especially in axSpA, TNFis have a greater effect than NSAIDs, which is mainly explained by a stronger effect on disease activity. We found no evidence for a direct link between CRP-mediated inflammation and depressive symptoms in SpA.
Study context
- Population
- Patients with SpA (axial or peripheral) from the ASAS Health Index Validation Study, assessed at baseline and after drug initiation260 axial SpA (axSpA), 44 peripheral SpA
- Participants
- 304 patients
- Exposure
- TNFi vs csDMARD vs NSAID initiation
- NSAIDsn = 102reference
- csDMARDsn = 45
- TNF inhibitors (TNFis)n = 157
- Outcome
- Change in depressive symptoms from baseline (HADS-D, 0-21, best-worst)
- Follow-up
- follow-up
Methodological detailsobservational, multivariable regression, analysis of variance
- Observational
- Multivariable regression
- Analysis of variance
Main finding
As reported in the abstract
Change in HADS-D from baseline (multivariable regression without disease activity measures)
β
−1.27
95% CI −2.23 to −0.32
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| Possible depression (HADS-D ≥8) · follow-upTNFisvs NSAIDs | 0.47 (0.23–0.94) | |
| 0.20.5125Odds ratio (log scale) |
Depression at baseline (all patients)
- Mean HADS-D (s.d. 4.2)
- 6.9
- Possibly depressed (HADS-D ≥8), n (%)
- 126 (42%)
- Probably depressed (HADS-D ≥11), n (%)
- 66 (22%)
Between-drug class results by SpA subtype (subgroup)
- Confirmed in axSpA, less clear in peripheral SpA
Original publication
The effect of anti-inflammatory treatment on depressive symptoms in spondyloarthritis: does the type of drug matter? Rheumatology (Oxford). Published 7 October 2022. doi:10.
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