Objective : The purpose of this study was to examine the relationships between levels of self-efficacy on health behavior of outpatients with rheumatoid arthritis (RA) and patient's assessment of RA conditions.
Methods : A cross-sectional study was performed using a self-administered anonymous questionnaire between October and December 2010 on 406 RA outpatients who consecutively visited 3 urban hospitals in Japan. The following variables were investigated ; (1) the scale of self-efficacy on health behavior in chronic disease patients (CD-SES), which has 2 subscales : active coping behavior with disease (14 items) and controllability for health (10 items). (2) The demographic data ; age, gender, duration of disease, treatment. (3) patient's assessment of RA conditions : painful joint count, swollen joint count, serum C reactive protein (CRP), patient estimate of global status (PGS) which was measured on a 100-mm visual analogue scale (0=best score), functional disability according to Japanese version of modified Health Assessment Questionnaire.
Results : CD-SES data were obtained from 191 patients. 80% was female with mean age 64.4 yr. Total CD-SES scores significantly correlated with age, PGS and functional disability. The scores of active coping behavior with disease correlated with age, and the scores of controllability for health correlated with PGS. The other variables such as painful joint counts, swollen joint counts, and serum CRP showed no relationship with the scores of self-efficacy.
Conclusion : Self-efficacy on health behavior of RA patients related to PGS and functional disability. The longitudinal study is necessary to ascertain whether the psychological support enhances self-efficacy, and affects clinically important outcome measures such as PGS.

BACKGROUND/AIMS: Recent genome-wide analyses have provided strong evidence concerning adverse events caused by thiopurine drugs such as azathioprine (AZA) and 6-mercaptopurine. The strong associations identified between NUDT15 p.Arg139Cys and thiopurine-induced leukopenia and severe hair loss have been studied and confirmed over the last 2 years. However, other coding variants, including NUDT15 p.Val18_Val19insGlyVal, NUDT15 p.Val18Ile, and FTO p.Ala134Thr, and a noncoding variation in RUNX1 (rs2834826) remain to be examined in detail in this respect. Therefore, we investigated the correlation between these adverse events and the 5 recently identified variants mentioned above among Japanese patients with inflammatory bowel diseases (IBD). METHODS: One hundred sixty thiopurine-treated patients with IBD were enrolled. Genotyping was performed using TaqMan SNP Genotyping Assays or Sanger sequencing. RESULTS: None of the 5 variants were associated with gastrointestinal intolerance to AZA. However, NUDT15 p.Arg139Cys was significantly associated with the interval between initiation and discontinuation of AZA among patients with gastrointestinal intolerance. This variant was strongly associated with early (<8 weeks) and late (≥8 weeks) leukopenia and severe hair loss. Moreover, it correlated with the interval between initiation of thiopurine therapy and leukopenia occurrence, and average thiopurine dose. NUDT15 p.Val18_Val19insGlyVal, NUDT15 p.Val18Ile, FTO p.Ala134Thr, and RUNX1 rs2834826 exhibited no significant relationship with the adverse events examined. CONCLUSIONS: Of the 5 variants investigated, NUDT15 p.Arg139Cys had the strongest impact on thiopurine-induced leukopenia and severe hair loss; therefore, its genotyping should be prioritized over that of other variants in efforts to predict these adverse events in Japanese patients with IBD.
6-Mercaptopurine ; Asian Continental Ancestry Group* ; Azathioprine ; Clinical Coding ; Hair ; Humans ; Inflammatory Bowel Diseases* ; Leukopenia