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    Secular changes in the progression of clinical markers and patient reported outcomes in early rheumatoid arthritis

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    Author
    Walsh, David A
    Keyword
    Inflammatory arthritis
    Cohort studies
    Longitudinal analysis
    Patient-reported outcomes
    Date
    2020-09
    
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    Publisher's URL
    https://academic.oup.com/rheumatology/article/59/9/2381/5695681
    Abstract
    Objectives To examine secular trends in the progression of clinical and patient-reported outcomes in early RA. Methods A total of 2701 patients recruited to the Early Rheumatoid Arthritis Study or Early Rheumatoid Arthritis Network with year of diagnosis from 1986 to 2011. The 5-year progression rates for patients diagnosed at different points in time were modelled using mixed-effects regression; 1990, 2002 and 2010, were compared. Clinical markers of disease included the 28-joint count DAS and the ESR. Patient-reported markers included the HAQ, visual analogue scale of pain and global health, and the Short-Form 36. Results Statistically significant improvements in both 28-joint count DAS and ESR were seen over the 5 years in patients diagnosed with RA compared with those diagnosed earlier. By 5 years, 59% of patients with diagnosis in 2010 were estimated to reach low disease activity compared with 48% with diagnosis in 2002 and 32% with diagnosis in 1990. Whilst HAQ demonstrated statistically significant improvements, these improvements were small, with similar proportions of patients achieving HAQ scores of ≤1.0 by 5 years with a diagnosis in 1990 compared with 2010. Levels of the visual analogue scale and the Mental Component Scores of the Short-Form 36 indicated similar, statistically non-significant levels over the 5 years, irrespective of year diagnosed. Conclusion This study demonstrates improvements in inflammatory markers over time in early RA, in line with improved treatment strategies. These have not translated into similar improvements in patient-reported outcomes relating to either physical or mental health.
    Citation
    Carpenter, L. et al. (2020) ‘Secular changes in the progression of clinical markers and patient-reported outcomes in early rheumatoid arthritis’, Rheumatology, 59(9), pp. 2381–2391
    Publisher
    Rheumatology
    Type
    Article
    URI
    http://hdl.handle.net/20.500.12904/15588
    Collections
    Rheumatology

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