THU0071 Time To Remission in Early Rheumatoid Arthritis Is Shorter in Early Arthritis Clinic Compared To Mixed Outpatient Clinic

2016 ◽  
Vol 75 (Suppl 2) ◽  
pp. 204.2-204
Author(s):  
T.H. Hansen ◽  
K.M. Carlsen ◽  
P. Johansen
Keyword(s):  
Rheumatoid Arthritis ◽  
Early Rheumatoid Arthritis ◽  
Outpatient Clinic ◽  
Early Arthritis

Earlier Time to Remission Predicts Sustained Clinical Remission in Early Rheumatoid Arthritis — Results from the Canadian Early Arthritis Cohort (CATCH)

2014 ◽  
Vol 41 (11) ◽  
pp. 2161-2166 ◽  
Author(s):  
Bindee Kuriya ◽  
Juan Xiong ◽  
Gilles Boire ◽  
Boulos Haraoui ◽  
Carol Hitchon ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trial ◽  
Clinical Practice ◽  
Early Rheumatoid Arthritis ◽  
Predictive Factors ◽  
Clinical Remission ◽  
Activity Index ◽  
Early Arthritis ◽  
Sustained Remission ◽  
Female Sex

Objective.To evaluate the prevalence and predictive factors of sustained remission in an early rheumatoid arthritis (ERA) population. Predictive factors of sustained remission in ERA are unknown. We hypothesized that a short time to remission is an important predictor of sustained clinical remission.Methods.Patients in the Canadian Early Arthritis Cohort were included. Remission was defined by Boolean-based American College of Rheumatology/European League Against Rheumatism clinical trial and clinical practice definitions and Simplified Disease Activity Index (SDAI). Logistic regression analysis identified predictors of sustained remission and influence of time to remission.Results.Of 1840 patients, 633 (34%) achieved clinical trial remission, 759 (41%) clinical practice remission, and 727 (39%) SDAI remission. Over half of those meeting remission criteria achieved sustained remission based on clinical trial (55%), clinical practice (60%), and/or SDAI (58%). Corticosteroid use and lack of initial disease-modifying antirheumatic drug (DMARD) were associated with decreased probability of sustained remission, while initial combination DMARD increased this probability. Female sex, greater pain, and longer time to first remission made sustained remission less likely.Conclusion.Female sex, greater pain, and lack of initial DMARD therapy reduced the probability of sustained remission. A shorter time to remission is related to sustainability and supports striving for early remission.

scholarly journals Patient-reported Outcomes as Predictors of Change in Disease Activity and Disability in Early Rheumatoid Arthritis: Results from the Yorkshire Early Arthritis Register

2017 ◽  
Vol 44 (9) ◽  
pp. 1331-1340 ◽  
Author(s):  
Sarah Twigg ◽  
Elizabeth M.A. Hensor ◽  
Paul Emery ◽  
Alan Tennant ◽  
Ann W. Morgan ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Early Rheumatoid Arthritis ◽  
Multilevel Models ◽  
Early Arthritis ◽  
Joint Disease ◽  
Symptom Duration ◽  
Rates Of Change ◽  
Patient Reported ◽  
Predictors Of Change

Objective.To assess patient-reported variables as predictors of change in disease activity and disability in early rheumatoid arthritis (RA).Methods.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.Results.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.Conclusion.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).

The Need to Better Classify and Diagnose Early and Very Early Rheumatoid Arthritis

2011 ◽  
Vol 39 (2) ◽  
pp. 212-217 ◽  
Author(s):  
HENNING ZEIDLER
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Practice ◽  
Early Rheumatoid Arthritis ◽  
Significant Risk ◽  
Early Arthritis ◽  
Classification Criteria ◽  
Future Research ◽  
Early Disease ◽  
Early Ra ◽  
Very Early Ra

Early rheumatoid arthritis (RA) and very early RA are major targets of research and clinical practice. Remission has become a realistic goal in the management of RA, particularly in early disease. The 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) RA classification criteria, the EULAR treatment recommendations for RA, and the EULAR recommendations for the management of early arthritis focus on early disease and translate the knowledge related to early RA into classification and management. Nevertheless, there is a need for further improvement and progress. Results from 6 recent studies are summarized, evaluating the performance of the 2010 ACR/EULAR RA classification criteria. The data show a significant risk of misclassification, and highlight that overdiagnosis and underdiagnosis may become important issues if the criteria recommend synthetic and biological disease-modifying antirheumatic drugs. Therefore, some considerations are presented on how the current problems and limitations could be overcome in clinical practice and future research. A consensus is needed to better define the early phase of RA and differentiate from other early arthritis. The possible effect of misclassification on spontaneous and drug-induced remission of early and very early RA awaits further elucidation. Such research will eventually lead to more reliable diagnostic and classification criteria for new-onset RA.

scholarly journals Effect of Age at Menopause on Disease Presentation in Early Rheumatoid Arthritis: Results From the Canadian Early Arthritis Cohort

2015 ◽  
Vol 67 (5) ◽  
pp. 616-623 ◽  
Author(s):  
Lauren E. Wong ◽  
Wei-Ti Huang ◽  
Janet E. Pope ◽  
Boulos Haraoui ◽  
Gilles Boire ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Early Rheumatoid Arthritis ◽  
Early Arthritis ◽  
Age At Menopause ◽  
Effect Of Age

Early Rheumatoid Arthritis Presentation, Treatment, and Outcomes in Aboriginal Patients in Canada: A Canadian Early Arthritis Cohort Study Analysis

2018 ◽  
Vol 70 (8) ◽  
pp. 1245-1250 ◽  
Author(s):  
Sujay Nagaraj ◽  
Cheryl Barnabe ◽  
Orit Schieir ◽  
Janet Pope ◽  
Susan J. Bartlett ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
Early Rheumatoid Arthritis ◽  
Early Arthritis ◽  
Study Analysis

Association Between Vitamin D Deficiency and Disease Activity, Disability, and Radiographic Progression in Early Rheumatoid Arthritis: The ESPOIR Cohort

2019 ◽  
Vol 47 (11) ◽  
pp. 1624-1628
Author(s):  
Gaël Mouterde ◽  
Etienne Gamon ◽  
Nathalie Rincheval ◽  
Cédric Lukas ◽  
Raphaele Seror ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Vitamin D ◽  
Disease Activity ◽  
Vitamin D Deficiency ◽  
Early Rheumatoid Arthritis ◽  
Radiographic Progression ◽  
Early Arthritis ◽  
Baseline Serum ◽  
Link Type ◽  
Early Ra

Objective.To evaluate the association of baseline serum level of vitamin D with disease activity, disability, and radiographic damage over the first year in early rheumatoid arthritis (RA).Methods.Among early arthritis patients included in the ESPOIR cohort, patients with early RA were evaluated. Levels of 25-hydroxy vitamin D2 and D3 were measured at baseline. Baseline associations between vitamin D level and 28-joint count Disease Activity Score based on erythrocyte sedimentation rate (DAS28-ESR), Health Assessment Questionnaire–Disability Index (HAQ-DI), and van der Heijde modified total Sharp score (mTSS) were assessed. Bivariate analysis was used to assess the association between vitamin D level and radiographic progression (mTSS increased by ≥ 1 point) or disability (HAQ-DI ≥ 0.5) over 12 months. Forward stepwise multiple logistic regression was used to evaluate the independent association of baseline variables and outcomes.Results.Among 813 patients with early arthritis, data for 645 patients with RA were analyzed. Vitamin D level was < 10 ng/mL (deficiency, group 1), 10–29.9 ng/mL (low level, group 2), and ≥ 30 ng/mL (normal, group 3) for 114 (17.7%), 415 (64.54%), and 114 (17.7%) patients, respectively. At baseline, DAS28-ESR and HAQ-DI were higher with vitamin D deficiency compared with groups 2 and 3 combined (P = 0.007 and P = 0.001, respectively), as was mean mTSS, but not significantly (p = 0.076). On multivariate analysis, baseline vitamin D deficiency was associated with HAQ-DI at 6 months (OR 1.70) and mTSS at 12 months (OR 1.76).Conclusion.Vitamin D deficiency was associated with more active and severe disease at baseline and may predict disability and radiographic progression over 1 year in early RA patients. [ClinicalTrials.gov: NCT03666091]

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