Characterization of disease course and remission in early seropositive rheumatoid arthritis: results from the TACERA longitudinal cohort study

Background: To characterise disease course and remission in a longitudinal observational study of newly diagnosed, initially treatment-naïve patients with seropositive rheumatoid arthritis (RA). Methods: Patients with early untreated seropositive RA were recruited from 28 UK centres. Multiple clinic...

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Formato:	article
Lenguaje:	EN
Publicado:	SAGE Publishing 2021
Materias:	Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/31fe8e2dbf49400b85b6ff1fad6ba97b
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spelling	oai:doaj.org-article:31fe8e2dbf49400b85b6ff1fad6ba97b2021-11-08T04:33:20ZCharacterization of disease course and remission in early seropositive rheumatoid arthritis: results from the TACERA longitudinal cohort study1759-721810.1177/1759720X211043977https://doaj.org/article/31fe8e2dbf49400b85b6ff1fad6ba97b2021-10-01T00:00:00Zhttps://doi.org/10.1177/1759720X211043977https://doaj.org/toc/1759-7218Background: To characterise disease course and remission in a longitudinal observational study of newly diagnosed, initially treatment-naïve patients with seropositive rheumatoid arthritis (RA). Methods: Patients with early untreated seropositive RA were recruited from 28 UK centres. Multiple clinical and laboratory measures were collected every 3 months for up to 18 months. Disease activity was measured using the 28-joint Disease Activity Score with C-reactive protein (DAS28-CRP) and Simplified Disease Activity Index (SDAI). Logistic regression models examined clinical predictors of 6-month remission and latent class mixed models characterised disease course. Results: We enrolled 275 patients of whom 267 met full eligibility and provided baseline data. According to SDAI definition, 24.3% attained 6-month remission. Lower baseline Health Assessment Questionnaire (HAQ) and SDAI predicted 6-month remission ( p = 0.013 and 0.011). Alcohol intake and baseline prescribing of methotrexate with a second disease-modifying antirheumatic drug (DMARD; vs monotherapy without glucocorticoids) were also predictive. Three distinct SDAI trajectory subpopulations emerged; corresponding to an inadequate responder group (6.5%), and higher and lower baseline activity responder groups (22.4% and 71.1%). Baseline HAQ and Short Form-36 Health Survey – Mental Component Score (SF-36 MCS) distinguished these groups. In addition, a number of baseline clinical predictors correlated with disease activity severity within subpopulations. Beneficial effects of alcohol intake were found across subpopulations. Conclusion: Three distinct disease trajectory subpopulations were identified. Differential effects of functional and mental well-being, alcohol consumption, and baseline RA medication prescribing on disease activity severity were found across subpopulations. Heterogeneity across trajectories cannot be fully explained by baseline clinical predictors. We hypothesise that biological markers collected early in disease course (within 6 months) may help patient management and better targeting of existing and novel therapies. SAGE PublishingarticleDiseases of the musculoskeletal systemRC925-935ENTherapeutic Advances in Musculoskeletal Disease, Vol 13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the musculoskeletal system RC925-935
spellingShingle	Diseases of the musculoskeletal system RC925-935 Characterization of disease course and remission in early seropositive rheumatoid arthritis: results from the TACERA longitudinal cohort study
description	Background: To characterise disease course and remission in a longitudinal observational study of newly diagnosed, initially treatment-naïve patients with seropositive rheumatoid arthritis (RA). Methods: Patients with early untreated seropositive RA were recruited from 28 UK centres. Multiple clinical and laboratory measures were collected every 3 months for up to 18 months. Disease activity was measured using the 28-joint Disease Activity Score with C-reactive protein (DAS28-CRP) and Simplified Disease Activity Index (SDAI). Logistic regression models examined clinical predictors of 6-month remission and latent class mixed models characterised disease course. Results: We enrolled 275 patients of whom 267 met full eligibility and provided baseline data. According to SDAI definition, 24.3% attained 6-month remission. Lower baseline Health Assessment Questionnaire (HAQ) and SDAI predicted 6-month remission ( p = 0.013 and 0.011). Alcohol intake and baseline prescribing of methotrexate with a second disease-modifying antirheumatic drug (DMARD; vs monotherapy without glucocorticoids) were also predictive. Three distinct SDAI trajectory subpopulations emerged; corresponding to an inadequate responder group (6.5%), and higher and lower baseline activity responder groups (22.4% and 71.1%). Baseline HAQ and Short Form-36 Health Survey – Mental Component Score (SF-36 MCS) distinguished these groups. In addition, a number of baseline clinical predictors correlated with disease activity severity within subpopulations. Beneficial effects of alcohol intake were found across subpopulations. Conclusion: Three distinct disease trajectory subpopulations were identified. Differential effects of functional and mental well-being, alcohol consumption, and baseline RA medication prescribing on disease activity severity were found across subpopulations. Heterogeneity across trajectories cannot be fully explained by baseline clinical predictors. We hypothesise that biological markers collected early in disease course (within 6 months) may help patient management and better targeting of existing and novel therapies.
format	article
title	Characterization of disease course and remission in early seropositive rheumatoid arthritis: results from the TACERA longitudinal cohort study
title_short	Characterization of disease course and remission in early seropositive rheumatoid arthritis: results from the TACERA longitudinal cohort study
title_full	Characterization of disease course and remission in early seropositive rheumatoid arthritis: results from the TACERA longitudinal cohort study
title_fullStr	Characterization of disease course and remission in early seropositive rheumatoid arthritis: results from the TACERA longitudinal cohort study
title_full_unstemmed	Characterization of disease course and remission in early seropositive rheumatoid arthritis: results from the TACERA longitudinal cohort study
title_sort	characterization of disease course and remission in early seropositive rheumatoid arthritis: results from the tacera longitudinal cohort study
publisher	SAGE Publishing
publishDate	2021
url	https://doaj.org/article/31fe8e2dbf49400b85b6ff1fad6ba97b
work_keys_str_mv	AT characterizationofdiseasecourseandremissioninearlyseropositiverheumatoidarthritisresultsfromthetaceralongitudinalcohortstudy
_version_	1718442986722820096

Characterization of disease course and remission in early seropositive rheumatoid arthritis: results from the TACERA longitudinal cohort study

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