Comparison of foot pain and foot care among rheumatoid arthritis patients taking and not taking anti-TNFα therapy: an epidemiological study

Abstract

Epidemiological studies report foot pain affects more than 90% of people with rheumatoid arthritis (RA). Most data about foot involvement in RA were collected prior to the availability of novel treatments such as biologics. Objective: To compare the prevalence of foot symptoms, frequency of foot examination and access to foot care services among RA patients currently treated with anti-TNFα compared with those not receiving biologics. Methods: A cross-sectional epidemiological study: a 28-item self-administered questionnaire was posted to 1040 people with RA throughout the UK. Results: Overall, 585 (55%) useable replies were received, 120 (20.5%) respondents were currently taking anti-TNFα medication. Prevalence of current foot pain was 99% among the biologics group compared with 76% not treated with biologics. Stiffness, swelling and numbness in the feet were all significantly more common in the anti-TNFα group (p<0.05). Most respondents (90%) taking biologics discussed their foot pain with their rheumatologist, but only 70% were receiving podiatry (compared to 78% not taking anti-TNFα). Subjects reported that their feet were examined significantly less frequently (p<0.001) than their hands. Conclusions: Foot complaints are common in this group and allied health professions could enhance rheumatological care by undertaking foot assessment.