Do people with rheumatoid arthritis maintain their physical activity level at treatment onset over the first year of methotrexate therapy?

To describe how many people with rheumatoid arthritis (RA) reduce their baseline physical activity (PA) level over the first year of methotrexate (MTX) treatment, and which factors predict this.Data came from the Rheumatoid Arthritis Medication Study (RAMS), a prospective cohort of people with early RA starting MTX. Participants reported demographics and completed questionnaires at baseline, six and 12 months, including reporting the number of days per week they performed ≥20 min of PA; coded as none, low (1-3 days) or high (4-7 days). The PA levels of participants over 12 months are described. Predictors of stopping PA were assessed using multivariable logistic regression.In total, 1468 participants were included (median [interquartile range] age: 60 [50, 69] years; 957 [65.2%] women). At baseline, the PA levels of the people with RA were: none = 408 (27.8%), low = 518 (35.3%), high = 542 (36.9%). 80% of participants maintained some PA or began PA between assessments (baseline to 6-months = 79.3%, 6-months to 12-months = 80.7%). 24.1% of participants reduced PA and 11.3% of participants stopped performing PA between baseline and 6-months (6-months to 12 months: 22.6% and 10.2% respectively). Baseline smoking, higher disability and greater socioeconomic deprivation were associated with stopping PA.Many people with early RA were not performing PA when starting MTX, or stopped performing PA over the first year of treatment. These people may require interventions to stay active. These interventions need to be mindful of socioeconomic barriers to PA participation.

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Authors: James M Gwinnutt, Husain Alsafar, Kimme L Hyrich, Mark Lunt, Anne Barton, Suzanne Mm Verstappen, RAMS co-investigators