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Radiographic damage in early rheumatoid arthritis is associated with increased disability but not with pain-a 5-year follow-up study

Eberhard, Anna LU ; Rydell, Emil LU orcid ; Forslind, Kristina LU ; Bergman, Stefan LU ; Mandl, Thomas LU ; Olofsson, Tor LU ; Jacobsson, Lennart T H LU and Turesson, Carl LU (2023) In Arthritis Research & Therapy 25. p.1-10
Abstract

OBJECTIVES: To evaluate how radiographic damage, overall and measured as joint space narrowing score (JSNS) and erosion score (ES), as well as other clinical and laboratory measures, relate to disability and pain in early rheumatoid arthritis (RA).

METHODS: An inception cohort of 233 patients with early RA, recruited in 1995-2005, was followed for 5 years. Disability was assessed with the Health Assessment Questionnaire (HAQ), and pain with a visual analogue scale (VAS; 0-100 mm). Radiographs of hands and feet were evaluated using the Sharp-van der Heijde score (SHS), including JSNS and ES. The relation for radiographic scores and other clinical parameters with pain and HAQ were evaluated cross-sectionally by multivariate linear... (More)

OBJECTIVES: To evaluate how radiographic damage, overall and measured as joint space narrowing score (JSNS) and erosion score (ES), as well as other clinical and laboratory measures, relate to disability and pain in early rheumatoid arthritis (RA).

METHODS: An inception cohort of 233 patients with early RA, recruited in 1995-2005, was followed for 5 years. Disability was assessed with the Health Assessment Questionnaire (HAQ), and pain with a visual analogue scale (VAS; 0-100 mm). Radiographs of hands and feet were evaluated using the Sharp-van der Heijde score (SHS), including JSNS and ES. The relation for radiographic scores and other clinical parameters with pain and HAQ were evaluated cross-sectionally by multivariate linear regression analysis and over time using generalized estimating equations.

RESULTS: ES was significantly associated with HAQ cross-sectionally at inclusion, after 2 and after 5 years, and over time. Associations for HAQ with SHS and JSNS were weaker and less consistent compared with those for ES. There was no association between radiographic scores and pain at any visit. Both HAQ and pain were associated with parameters of disease activity. The strongest cross-sectional associations were found for the number of tender joints (adjusted p<0.001 at all visits).

CONCLUSION: Joint damage was associated with disability already in early RA. Erosions of hands and feet appear to have a greater influence on disability compared with joint space narrowing early in the disease. Pain was associated with other factors than joint destruction in early RA, in particular joint tenderness-suggesting an impact of pain sensitization.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Humans, Follow-Up Studies, Cross-Sectional Studies, Arthritis, Rheumatoid/complications, Pain/diagnostic imaging, Arthralgia
in
Arthritis Research & Therapy
volume
25
article number
29
pages
1 - 10
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85148976040
  • pmid:36849881
ISSN
1478-6354
DOI
10.1186/s13075-023-03015-9
language
English
LU publication?
yes
additional info
© 2023. The Author(s).
id
450aca49-463b-44b5-b1cd-83d767398a3d
date added to LUP
2023-03-01 20:36:38
date last changed
2024-06-13 16:27:21
@article{450aca49-463b-44b5-b1cd-83d767398a3d,
  abstract     = {{<p>OBJECTIVES: To evaluate how radiographic damage, overall and measured as joint space narrowing score (JSNS) and erosion score (ES), as well as other clinical and laboratory measures, relate to disability and pain in early rheumatoid arthritis (RA).</p><p>METHODS: An inception cohort of 233 patients with early RA, recruited in 1995-2005, was followed for 5 years. Disability was assessed with the Health Assessment Questionnaire (HAQ), and pain with a visual analogue scale (VAS; 0-100 mm). Radiographs of hands and feet were evaluated using the Sharp-van der Heijde score (SHS), including JSNS and ES. The relation for radiographic scores and other clinical parameters with pain and HAQ were evaluated cross-sectionally by multivariate linear regression analysis and over time using generalized estimating equations.</p><p>RESULTS: ES was significantly associated with HAQ cross-sectionally at inclusion, after 2 and after 5 years, and over time. Associations for HAQ with SHS and JSNS were weaker and less consistent compared with those for ES. There was no association between radiographic scores and pain at any visit. Both HAQ and pain were associated with parameters of disease activity. The strongest cross-sectional associations were found for the number of tender joints (adjusted p&lt;0.001 at all visits).</p><p>CONCLUSION: Joint damage was associated with disability already in early RA. Erosions of hands and feet appear to have a greater influence on disability compared with joint space narrowing early in the disease. Pain was associated with other factors than joint destruction in early RA, in particular joint tenderness-suggesting an impact of pain sensitization.</p>}},
  author       = {{Eberhard, Anna and Rydell, Emil and Forslind, Kristina and Bergman, Stefan and Mandl, Thomas and Olofsson, Tor and Jacobsson, Lennart T H and Turesson, Carl}},
  issn         = {{1478-6354}},
  keywords     = {{Humans; Follow-Up Studies; Cross-Sectional Studies; Arthritis, Rheumatoid/complications; Pain/diagnostic imaging; Arthralgia}},
  language     = {{eng}},
  month        = {{02}},
  pages        = {{1--10}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Arthritis Research & Therapy}},
  title        = {{Radiographic damage in early rheumatoid arthritis is associated with increased disability but not with pain-a 5-year follow-up study}},
  url          = {{http://dx.doi.org/10.1186/s13075-023-03015-9}},
  doi          = {{10.1186/s13075-023-03015-9}},
  volume       = {{25}},
  year         = {{2023}},
}