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dc.contributor.authorWalsh, David A
dc.date.accessioned2022-06-10T14:02:23Z
dc.date.available2022-06-10T14:02:23Z
dc.date.issued2020-06
dc.identifier.citationNikiphorou, E. et al. (2020) ‘Remission vs low disease activity: function, quality of life and structural outcomes in the Early Rheumatoid Arthritis Study and Network’, Rheumatology, 59(6), pp. 1272–1280en_US
dc.identifier.urihttp://hdl.handle.net/20.500.12904/15590
dc.description.abstractObjectives: To examine associations between function, quality of life and structural outcomes in patients achieving remission vs low disease activity in early RA. Methods: Demographic, clinical and radiographic variables were collected at baseline and then annually from the Early Rheumatoid Arthritis Study (ERAS) and Early Rheumatoid Arthritis Network (ERAN) inception cohorts in routine care from 1986 to 2012. Disease activity was categorized: mean DAS28 score between years 1 and 5: remission [mean remission DAS (mRDAS) <2.6] or low [mean low DAS (mLDAS) 2.6-3.2]; sustained low/remission DAS28 (sLDAS/sRDAS) at years 1 and 2; and sustained Boolean remission (sBR) at years 1 and 2. Changes in HAQ and Short Form 36 Health Survey Questionnaire [SF-36; physical (PCS) and mental (MCS) component score]) and total Sharp van der Heijde (SvdH) scores for each disease activity category were modelled using multi-level models. Covariates included year of onset, age, gender and DMARD use at first visit. Results: Of 2701 patients, 562 (21%) were categorized mRDAS, 330 (12%) mLDAS, 279 (10%) sRDAS, 203 (7.5%) sLDAS and 93 (3%) sBR. Patients categorized as mRDAS had increasingly divergent improved HAQ, SF-36 PCS, MCS and total SvdH scores compared with mLDAS (P-values 0.001 to <0.0001, all time points). Patients categorized as sRDAS had better HAQ, SF-36 PCS and MCS scores (P-values 0.05 to <0.0001, all time points) and SvdH scores (P = 0.05, years 3-5) over sLDAS. sBR was associated with better HAQ, and SF-36 PCS and MCS scores over sLDAS (P-values 0.002 to <0.0001, all time points). Conclusion: These findings from routine care support ACR/EULAR guidelines that remission is a preferable goal over low disease activity in early RA.
dc.description.urihttps://academic.oup.com/rheumatology/article/59/6/1272/5580604en_US
dc.publisherReumatologyen_US
dc.subjectDamageen_US
dc.subjectFunctionen_US
dc.subjectLife qualityen_US
dc.subjectLow disease activityen_US
dc.subjectRemissionen_US
dc.subjectRheumatoid arthritisen_US
dc.titleRemission vs low disease activity: function, quality of life and structural outcomes in the Early Rheumatoid Arthritis Study and Networken_US
dc.typeArticleen_US
rioxxterms.funderDefault funderen_US
rioxxterms.identifier.projectDefault projecten_US
rioxxterms.versionNAen_US
rioxxterms.versionofrecord10.1093/rheumatology/kez461en_US
rioxxterms.typeJournal Article/Reviewen_US
refterms.dateFOA2022-06-10T14:02:23Z
refterms.panelUnspecifieden_US
html.description.abstractObjectives: To examine associations between function, quality of life and structural outcomes in patients achieving remission vs low disease activity in early RA. Methods: Demographic, clinical and radiographic variables were collected at baseline and then annually from the Early Rheumatoid Arthritis Study (ERAS) and Early Rheumatoid Arthritis Network (ERAN) inception cohorts in routine care from 1986 to 2012. Disease activity was categorized: mean DAS28 score between years 1 and 5: remission [mean remission DAS (mRDAS) <2.6] or low [mean low DAS (mLDAS) 2.6-3.2]; sustained low/remission DAS28 (sLDAS/sRDAS) at years 1 and 2; and sustained Boolean remission (sBR) at years 1 and 2. Changes in HAQ and Short Form 36 Health Survey Questionnaire [SF-36; physical (PCS) and mental (MCS) component score]) and total Sharp van der Heijde (SvdH) scores for each disease activity category were modelled using multi-level models. Covariates included year of onset, age, gender and DMARD use at first visit. Results: Of 2701 patients, 562 (21%) were categorized mRDAS, 330 (12%) mLDAS, 279 (10%) sRDAS, 203 (7.5%) sLDAS and 93 (3%) sBR. Patients categorized as mRDAS had increasingly divergent improved HAQ, SF-36 PCS, MCS and total SvdH scores compared with mLDAS (P-values 0.001 to <0.0001, all time points). Patients categorized as sRDAS had better HAQ, SF-36 PCS and MCS scores (P-values 0.05 to <0.0001, all time points) and SvdH scores (P = 0.05, years 3-5) over sLDAS. sBR was associated with better HAQ, and SF-36 PCS and MCS scores over sLDAS (P-values 0.002 to <0.0001, all time points). Conclusion: These findings from routine care support ACR/EULAR guidelines that remission is a preferable goal over low disease activity in early RA.en_US
rioxxterms.funder.project94a427429a5bcfef7dd04c33360d80cden_US


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