Differences between the Health Assessment Questionnaire Disability Index (HAQ-DI) and the modified HAQ (mHAQ) score before and after infliximab treatment in patients with rheumatoid arthritis

Abstract

We conducted a 1-year prospective study to clarify differences between the Health Assessment Questionnaire disability index (HAQ-DI) and the modified HAQ (mHAQ) score among rheumatoid arthritis (RA) patients treated with infliximab. A total of 87 patients were scheduled to receive infliximab infusion at a dose of 3 mg/kg at weeks 0, 2, and 6, and every 8 weeks thereafter for 54 weeks; all patients received a full examination at each infusion appointment. The 28-joint disease activity score (DAS28) and functional capability of each patient was assessed at each visit, using the HAQ-DI and the mHAQ score. A strong correlation was observed between the HAQ-DI and the mHAQ score at baseline (r = 0.892). Over the course of the treatment, the mean mHAQ score changed similarly to the HAQ-DI, but the mean HAQ-DI was significantly higher than the mean mHAQ score at each time-point (for the HAQ-DI vs. mHAQ score, baseline: 1.5 ± 0.7 vs. 0.9 ± 0.6, p < 0.0001; 6 weeks: 1.1 ± 0.7 vs. 0.6 ± 0.5, p < 0.0001; 30 weeks: 1.0 ± 0.7 vs. 0.6 ± 0.5, p < 0.0001; 54 weeks: 0.9 ± 0.7 vs. 0.6 ± 0.6, p = 0.0006). In the categories of “eating”, “reaching”, and “other activities”, the scores for several items excluded from the mHAQ score were significantly higher than those included in the mHAQ score over the year-long study period. We identified items contributing to significant differences between the HAQ-DI and the mHAQ score among RA patients treated with infliximab.

Keywords::

• 28-Joint disease activity score (DAS28)
• Health Assessment Questionnaire Disability Index (HAQ-DI)
• Modified Health Assessment Questionnaire (mHAQ) score
• Infliximab
• Rheumatoid arthritis