Effect of Fatigue, Older Age, Higher Body Mass Index, and Female Sex on Disability in Early Rheumatoid Arthritis in the Treatment‐to‐Target Era. Issue 3 (9th February 2018)

• Record Type: Journal Article
• Authors: Twigg, Sarah; Hensor, Elizabeth M. A.; Freeston, Jane; Tan, Ai Lyn; Emery, Paul; Tennant, Alan; Morgan, Ann W.
• Other Names: Conaghan Philip investigator.; Keenan Anne‐Maree investigator.; Hensor Elizabeth investigator.; Quinn Mark investigator.; Gough Andrew investigator.; Green Michael investigator.; Reece Richard investigator.; Hordon Lesley investigator.; Helliwell Philip investigator.; Melsom Richard investigator.; Doherty Sheelagh investigator.; Adebajo Ade investigator.; Harvey Andrew investigator.; Jarrett Steve investigator.; Huston Gareth investigator.; Isdale Amanda investigator.; Martin Mike investigator.; Karim Zunaid investigator.; McGonagle Dennis investigator.; Pease Colin investigator.; Cox Sally investigator.; Bejarano Victoria investigator.; Nam Jackie investigator.; Villeneuve Edith investigator.; Brown Claire investigator.; Thomas Christine investigator.; Pickles David investigator.; Hammond Alison investigator.; Neville Beverley investigator.; Fairclough Alan investigator.; Nunns Caroline investigator.; Gill Anne investigator.; Green Julie investigator.; Rhys‐Evans Belinda investigator.; Padwell Barbara investigator.; Madden Julie investigator.; Taylor Lynda investigator.; Smith Sally investigator.; King Heather investigator.; Firth Jill investigator.; Heard Jayne investigator.; Sigsworth Linda investigator.; Corscadden Diane investigator.; Henshaw Karen investigator.; Rashid Lubna‐Haroon investigator.; Martin Stephen investigator.; Robinson James investigator.; Kozera Lukasz investigator.; Burksa Agata investigator.; Fahy Sarah investigator.; Paterson Andrea investigator.; Hensor Elizabeth investigator.; Ponchel Frederique investigator.; Buch Maya investigator.; Nam Jackie investigator.; Villeneuve Edith investigator.; Conaghan Philip investigator.; Andrews Jacqueline investigator.; Wakefield Richard investigator.; McGonagle Denis investigator.; Marzo‐Ortega Helena investigator.; Das Sudipto investigator.; Horton Sarah investigator.; Mackie Sarah investigator.; Thomas Rebecca investigator.; Bissell Lesley Ann investigator.; Rakieh Chadi investigator.; Ash Zoe investigator.; Aslam Amir investigator.; Saleem Benazir investigator.; Coates Laura investigator.; Fazal Fahad investigator.; Hunt Laura investigator.; Vital Ed investigator.; Ferguson Esme investigator.; Else Sara investigator.; Tran Gui investigator.; Zayat Ahmed investigator.; Abignano Guiseppina investigator.; Yousef Yuz investigator.; Raghunath Radhika investigator.; Mathieson Hannah investigator.; Ramakumain Chitra investigator.; Gul Hanna investigator.; Mahmood Mahwish investigator.; Fitzgerald Pauline investigator.; Robinson Matthew investigator.; Ward Jason investigator.; Wells Beverly investigator.; Pickles David investigator.; Wordsworth Oliver investigator.; Thomas Christine investigator.; McManus Alison investigator.; Bailey Lynda investigator.; Gray Linda investigator.; Fitzgerald Pauline investigator.; Russell Kate investigator.; Davies Jayne investigator.; Corscadden Diane investigator.; Henshaw Karen investigator.; Rashid Lubna‐Haroon investigator.; Martin Stephen investigator.; Robinson James investigator.; Kozera Lukasz investigator.; Burksa Agata investigator.; Mbara Katie investigator.; Fahy Sarah investigator.; Halsted‐Rastrick Jill investigator.; Connoly‐Thompson Ged investigator.; Thompson Jonathan investigator.; Weatherill Ian investigator.; Paterson Andrea investigator.; Horton Laura investigator.; Jackson Alwyn investigator.; Hodgson Richard investigator.;
• Is Part Of: Arthritis care & research. Volume 70:Issue 3(2018)
• Page Start: 361
• Page End: 368
• Publication Date: 2018-02-09
• Subjects: Arthritis -- Periodicals; Rheumatism -- Periodicals; 616.72
• DOI: 10.1002/acr.23281
• Languages: English
• ISSNs: 2151-464X

Abstract

Abstract : Objective: To compare disease activity and disability over 2 years in early rheumatoid arthritis (RA) before and after implementation of treat‐to‐target therapy and identify predictors of adverse outcome. Methods: The Yorkshire Early Arthritis Register (YEAR) recruited 725 patients with early RA between 2002 and 2009, treated with a step‐up approach. The Inflammatory Arthritis Continuum study (IACON) recruited cases between 2010 and 2014 and treated to target. A total of 384 IACON cases met 2010 American College of Rheumatology/European League Against Rheumatism criteria. Latent growth curves of change in Disease Activity Score in 28 joints (DAS28) and the Health Assessment Questionnaire (HAQ) were compared between YEAR and IACON. Latent class growth analysis identified trajectories of change. Baseline predictors of trajectories were identified using logistic regression. Results: The mean DAS28 over 2 years was lower in IACON than in YEAR. Latent trajectories of HAQ change in YEAR were high stable (21% of cohort), moderate reducing (35%), and low reducing (44%). Only moderate reducing (66%) and low reducing (34%) were seen in IACON. In both cohorts, female sex and fatigue predicted adverse HAQ trajectories (high stable and moderate reducing). Odds ratios (ORs) for moderate reducing compared to low reducing for women were 2.58 (95% confidence interval [95% CI] 1.69, 4.49) in YEAR and 5.81 (95% CI 2.44, 14.29) in IACON. ORs per centimeter fatigue visual analog score were 1.13 (95% CI 1.07, 1.20) in YEAR and 1.16 (95% CI 1.12, 1.20) in IACON. Conclusion: Treat‐to‐target therapy gave more favorable trajectories of change in DAS28 and HAQ, but adverse HAQ trajectory was more likely in women with greater fatigue, suggesting such patients would benefit from interventions to improve function as well as reduce inflammation.