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Predictors of remission, normalized physical function, and changes in the working situation during follow-up of patients with early rheumatoid arthritis: an observational study.
Scand J Rheumatol. 2009 May-Jun; 38(3):166-72.SJ

Abstract

OBJECTIVES

To evaluate possible predictors of remission, normalized physical function, and work change in rheumatoid arthritis (RA).

METHODS

We determined in our early RA cohort the proportion of patients in remission [Disease Activity Score (DAS28)<2.6], with normalized function [Health Assessment Questionnaire (HAQ) = 0], and with changed working situation since disease onset. Candidate predictors of remission, normalized function, and work change were studied by subgroup comparison and logistic regression analysis, including demographics, education, rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) antibodies, treatment, and DAS28, HAQ, pain and fatigue scores (on the visual analogue scale, VAS).

RESULTS

Median (interquartile range, IQR) disease duration was 18 (29) months. Of 89 patients included, 69% were in remission. DAS28, HAQ, pain and fatigue scores of these patients were lower throughout year 1, although similar at baseline, compared to patients not in remission. At month 4, more of these patients were already good responders. Remission at month 4 independently predicted remission at follow-up. Thirty-eight per cent had no functional limitations; compared to patients with limitations, they had a lower baseline HAQ and lower DAS28, HAQ, pain and fatigue scores during year 1. At month 4, more achieved remission or HAQ = 0. Male sex, baseline HAQ, and month 4 good European League Against Rheumatism (EULAR) response predicted long-term HAQ = 0, but month 4 HAQ = 0 was the strongest independent predictor. Of the 40% with a paid job at baseline, 43.8% reported changes in their work situation; they had higher DAS28, HAQ, pain and fatigue scores during year 1. Failing a month 4 good EULAR response independently predicted work change.

CONCLUSION

Month 4 disease response predicts later remission, normalized physical function, and work change in RA.

Authors+Show Affiliations

Department of Rheumatology, University Hospitals, Leuven, Belgium. patrick.verschueren@uz.kuleuven.ac.beNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19169906

Citation

Verschueren, P, et al. "Predictors of Remission, Normalized Physical Function, and Changes in the Working Situation During Follow-up of Patients With Early Rheumatoid Arthritis: an Observational Study." Scandinavian Journal of Rheumatology, vol. 38, no. 3, 2009, pp. 166-72.
Verschueren P, Esselens G, Westhovens R. Predictors of remission, normalized physical function, and changes in the working situation during follow-up of patients with early rheumatoid arthritis: an observational study. Scand J Rheumatol. 2009;38(3):166-72.
Verschueren, P., Esselens, G., & Westhovens, R. (2009). Predictors of remission, normalized physical function, and changes in the working situation during follow-up of patients with early rheumatoid arthritis: an observational study. Scandinavian Journal of Rheumatology, 38(3), 166-72. https://doi.org/10.1080/03009740802484846
Verschueren P, Esselens G, Westhovens R. Predictors of Remission, Normalized Physical Function, and Changes in the Working Situation During Follow-up of Patients With Early Rheumatoid Arthritis: an Observational Study. Scand J Rheumatol. 2009 May-Jun;38(3):166-72. PubMed PMID: 19169906.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of remission, normalized physical function, and changes in the working situation during follow-up of patients with early rheumatoid arthritis: an observational study. AU - Verschueren,P, AU - Esselens,G, AU - Westhovens,R, PY - 2009/1/27/entrez PY - 2009/1/27/pubmed PY - 2009/5/22/medline SP - 166 EP - 72 JF - Scandinavian journal of rheumatology JO - Scand J Rheumatol VL - 38 IS - 3 N2 - OBJECTIVES: To evaluate possible predictors of remission, normalized physical function, and work change in rheumatoid arthritis (RA). METHODS: We determined in our early RA cohort the proportion of patients in remission [Disease Activity Score (DAS28)<2.6], with normalized function [Health Assessment Questionnaire (HAQ) = 0], and with changed working situation since disease onset. Candidate predictors of remission, normalized function, and work change were studied by subgroup comparison and logistic regression analysis, including demographics, education, rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) antibodies, treatment, and DAS28, HAQ, pain and fatigue scores (on the visual analogue scale, VAS). RESULTS: Median (interquartile range, IQR) disease duration was 18 (29) months. Of 89 patients included, 69% were in remission. DAS28, HAQ, pain and fatigue scores of these patients were lower throughout year 1, although similar at baseline, compared to patients not in remission. At month 4, more of these patients were already good responders. Remission at month 4 independently predicted remission at follow-up. Thirty-eight per cent had no functional limitations; compared to patients with limitations, they had a lower baseline HAQ and lower DAS28, HAQ, pain and fatigue scores during year 1. At month 4, more achieved remission or HAQ = 0. Male sex, baseline HAQ, and month 4 good European League Against Rheumatism (EULAR) response predicted long-term HAQ = 0, but month 4 HAQ = 0 was the strongest independent predictor. Of the 40% with a paid job at baseline, 43.8% reported changes in their work situation; they had higher DAS28, HAQ, pain and fatigue scores during year 1. Failing a month 4 good EULAR response independently predicted work change. CONCLUSION: Month 4 disease response predicts later remission, normalized physical function, and work change in RA. SN - 1502-7732 UR - https://www.unboundmedicine.com/medline/citation/19169906/Predictors_of_remission_normalized_physical_function_and_changes_in_the_working_situation_during_follow_up_of_patients_with_early_rheumatoid_arthritis:_an_observational_study_ L2 - https://www.tandfonline.com/doi/full/10.1080/03009740802484846 DB - PRIME DP - Unbound Medicine ER -