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Patients with early rheumatoid arthritis in the 2000s have equal disability and pain despite less disease activity compared with the 1990s : Data from the barfot study over 8 years

Andersson, Maria L.E. LU ; Forslind, Kristina LU and Hafström, Ingiäld (2017) In Journal of Rheumatology 44(6). p.723-731
Abstract

Objective. To compare outcomes over the first 8 years in patients with early rheumatoid arthritis (RA) recruited in the 1990s and the 2000s, with a special focus on functional disability and its possible predictors. Methods. Data were acquired from 1938 patients with early RA (American College of Rheumatology 1987 criteria) included in the BARFOT study, who had completed the 8-year followup. The patients were divided into 2 cohorts: cohort 1 (n = 928, 68% women) included from 1992 to 1999 and cohort 2 (n = 1010, 70% women) included from 2000 to 2006. Health Assessment Questionnaire (HAQ), 28-joint Disease Activity Score (DAS28), visual analog scale pain, and radiographs of hands and feet scored by the van der Heijde modified Sharp... (More)

Objective. To compare outcomes over the first 8 years in patients with early rheumatoid arthritis (RA) recruited in the 1990s and the 2000s, with a special focus on functional disability and its possible predictors. Methods. Data were acquired from 1938 patients with early RA (American College of Rheumatology 1987 criteria) included in the BARFOT study, who had completed the 8-year followup. The patients were divided into 2 cohorts: cohort 1 (n = 928, 68% women) included from 1992 to 1999 and cohort 2 (n = 1010, 70% women) included from 2000 to 2006. Health Assessment Questionnaire (HAQ), 28-joint Disease Activity Score (DAS28), visual analog scale pain, and radiographs of hands and feet scored by the van der Heijde modified Sharp method were assessed during the 8 years. Longitudinal data analyses were performed using a generalized linear model. Results. Despite more active medical treatment during the 2000s, the courses of HAQ and pain showed no difference between the cohorts during followup, in either women or in men, with significantly higher levels in women compared with men. However, as expected, disease activity decreased more over time in cohort 2 compared with cohort 1, for both sexes, and women in cohort 2 had less radiographic progression compared with cohort 1. HAQ was associated with DAS28, pain, radiological scores, and sex in both cohorts, and in cohort 2 also with age and smoking. Conclusion. Patients included in the 2000s had lower disease activity, but not less activity limitation and pain over 8 years of followup despite more active treatment. Pain, aging, and smoking might explain why patients included in the 2000s still had the same disability levels as those included in the 1990s.

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author
organization
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type
Contribution to journal
publication status
published
subject
keywords
DiSEASE ACTIVITY, EARLY RHEUMATOID ARTHRITIS, HEALTH ASSESSMENT QUESTIONNAIRE, PAIN
in
Journal of Rheumatology
volume
44
issue
6
pages
9 pages
publisher
J Rheumatol Publ Co
external identifiers
  • scopus:85020176397
  • wos:000404641800004
ISSN
0315-162X
DOI
10.3899/jrheum.161235
language
English
LU publication?
yes
id
24d40670-2c0b-4aa1-a43a-107f28300788
date added to LUP
2017-08-17 13:12:32
date last changed
2017-11-17 03:00:14
@article{24d40670-2c0b-4aa1-a43a-107f28300788,
  abstract     = {<p>Objective. To compare outcomes over the first 8 years in patients with early rheumatoid arthritis (RA) recruited in the 1990s and the 2000s, with a special focus on functional disability and its possible predictors. Methods. Data were acquired from 1938 patients with early RA (American College of Rheumatology 1987 criteria) included in the BARFOT study, who had completed the 8-year followup. The patients were divided into 2 cohorts: cohort 1 (n = 928, 68% women) included from 1992 to 1999 and cohort 2 (n = 1010, 70% women) included from 2000 to 2006. Health Assessment Questionnaire (HAQ), 28-joint Disease Activity Score (DAS28), visual analog scale pain, and radiographs of hands and feet scored by the van der Heijde modified Sharp method were assessed during the 8 years. Longitudinal data analyses were performed using a generalized linear model. Results. Despite more active medical treatment during the 2000s, the courses of HAQ and pain showed no difference between the cohorts during followup, in either women or in men, with significantly higher levels in women compared with men. However, as expected, disease activity decreased more over time in cohort 2 compared with cohort 1, for both sexes, and women in cohort 2 had less radiographic progression compared with cohort 1. HAQ was associated with DAS28, pain, radiological scores, and sex in both cohorts, and in cohort 2 also with age and smoking. Conclusion. Patients included in the 2000s had lower disease activity, but not less activity limitation and pain over 8 years of followup despite more active treatment. Pain, aging, and smoking might explain why patients included in the 2000s still had the same disability levels as those included in the 1990s.</p>},
  author       = {Andersson, Maria L.E. and Forslind, Kristina and Hafström, Ingiäld},
  issn         = {0315-162X},
  keyword      = {DiSEASE ACTIVITY,EARLY RHEUMATOID ARTHRITIS,HEALTH ASSESSMENT QUESTIONNAIRE,PAIN},
  language     = {eng},
  month        = {06},
  number       = {6},
  pages        = {723--731},
  publisher    = {J Rheumatol Publ Co},
  series       = {Journal of Rheumatology},
  title        = {Patients with early rheumatoid arthritis in the 2000s have equal disability and pain despite less disease activity compared with the 1990s : Data from the barfot study over 8 years},
  url          = {http://dx.doi.org/10.3899/jrheum.161235},
  volume       = {44},
  year         = {2017},
}