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To assess patient-reported variables as predictors of change in disease activity and disability in early rheumatoid arthritis (RA).
In this study,
various patient-related outcomes can be used as a diagnostic tool to evaluate
changes occurring in disease activity and disability in patients having early
RA. This study can be a powerful basis to evaluate RA progression.
To assess
patient-reported variables as predictors of change in disease activity and
disability in early rheumatoid arthritis (RA).
Cases were
recruited to the Yorkshire Early Arthritis Register (YEAR) between 1997 and
2009 (n = 1415). Predictors of the 28-joint Disease Activity Score (DAS28) and
the Health Assessment Questionnaire-Disability Index (HAQ-DI) at baseline and
change over 12 months were identified using multilevel models. Baseline
predictors were sex, age, symptom duration, autoantibody status, pain and
fatigue visual analog scales (VAS), duration of early morning stiffness (EMS),
DAS28, and HAQ-DI.
Rates of change
were slower in women than men: DAS28 fell by 0.19 and 0.17 units/month, and
HAQ-DI by 0.028 and 0.023 units/month in men and women, respectively. Baseline
pain and EMS had small effects on rates of change, whereas fatigue VAS was only
associated with DAS28 and HAQ-DI at baseline. In patients recruited up to 2002,
DAS28 reduced more quickly in those with greater pain at baseline (by 0.01
units/mo of DAS28 per cm pain VAS, p = 0.024); in patients recruited after
2002, the effect for pain was stronger (by 0.01 units/mo, p = 0.087). DAS28
reduction was greater with longer EMS. In both cohorts, fall in HAQ-DI (p =
0.006) was greater in patients with longer EMS duration, but pain and fatigue
were not significant predictors of change in HAQ-DI.
Patient-reported
fatigue, pain, and stiffness at baseline are of limited value for the
prediction of RA change in disease activity (DAS28) and activity limitation
(HAQ-DI).
J Rheumatol. 2017 Jul 1.
Patient-reported Outcomes as Predictors of Change in Disease Activity and Disability in Early Rheumatoid Arthritis: Results from the Yorkshire Early Arthritis Register
Twigg S et al.
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