How does functional disability in early rheumatoid arthritis (RA) affect patients and their lives? Results of 5 years of follow‐up in 732 patients from the Early RA Study (ERAS)

Young, Adam; Dixey, Josh; Cox, Nigel; Davies, Paul; Devlin, Joe; Emery, Paul; Gallivan, S; Gough, Andrew; James, David W.; Prouse, P.; Williams, Peter; Winfield, John B.

doi:10.1093/rheumatology/39.6.603

Cited by 252 publications

(159 citation statements)

References 22 publications

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“…Together with some traditional risk factors for disability such as female sex and older age (8,11), the results of our study confirmed an association between the delay in diagnosis and in starting treatment with MTX and higher HAQ scores. These findings are in line with current EULAR recommendations on the treatment of patients with RA, which suggest that therapy with DMARDs should be started as soon as the diagnosis is made (2).…”

Section: N Discussionsupporting

confidence: 83%

The impact on disability of initial treatment with methotrexate in patients with rheumatoid arthritis: results from the MARI study

et al. 2016

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The study aimed to assess in a population of subjects with rheumatoid arthritis (RA) treated with methotrexate (MTX) how the initial approach to the treatment influenced subsequent disability. We performed a cross-sectional analysis of data collected during the baseline visit of the MARI study, a multicenter observational study on patients with RA on treatment with MTX for at least 12 months. Subjects who fulfilled the Health Assessment Questionnaire (HAQ) were included in the evaluation. For every patient we retrospectively evaluated the disease duration, the duration of symptoms before the diagnosis, the time elapsed before first MTX treatment, the initial MTX dose, and the concomitant medications in the first six months of therapy. Disability was defined as a DI-HAQ score ≥1. The study population included 1015 subjects. Patients with a DI-HAQ score ≥1 had a longer duration of symptoms before diagnosis, a higher delay in treatment initiation, a lower initial dose of MTX and a more frequent co-treatment with symptomatic drugs. Disability was found less frequently in subjects treated with other concomitant disease modifying anti-rheumatic drugs (DMARDs) but not with biological agents. Logistic regression analysis identified as significant predictors of disability: older age, female sex, a longer time to complete diagnosis, a delay in starting MTX treatment higher than 6 months, and a concomitant treatment with symptomatic drugs, while a combination therapy with other DMARDs was associated with a lower risk of disability. A late diagnosis and a delay in starting a treatment with MTX are associated with poorer functional outcomes in patients with RA.

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Section: N Discussionsupporting

confidence: 83%

The impact on disability of initial treatment with methotrexate in patients with rheumatoid arthritis: results from the MARI study

et al. 2016

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“…The activity limitations seen 3 years after the diagnosis of RA were of approximately the same magnitude as those seen after 1 and 2 years in both women and men (5). Several investigators, using the HAQ, have reported more pronounced activity limitations in women than men (2,4,(13)(14)(15)18,35), and this finding, together with a majority of other self-reported outcome measures, has …”

Section: Discussionmentioning

confidence: 65%

“…However, early in the disease course, the inflammatory process leads to a multitude of functional limitations (1)(2)(3)(4)(5). Several studies have also shown that RA is associated with a shortened life span, mainly due to coronary vascular disease (6 -8).…”

Section: Introductionmentioning

confidence: 99%

“…Two recent Swedish studies on early RA have found that women on average have more pronounced difficulties in performing daily activities than men as reflected by the HAQ (13,14). Apart from sex, factors such as age, disease activity, and joint destruction have been found to correlate with HAQ score (4,(15)(16)(17)(18). Also, by using another instrument designed to evaluate activity limitations in patients with RA, the Evaluation of Study group.…”

Section: Introductionmentioning

confidence: 99%

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Activity limitation in rheumatoid arthritis correlates with reduced grip force regardless of sex: The Swedish TIRA project

Thyberg¹,

Hass²,

Nordenskiöld³

et al. 2005

Arthritis & Rheumatism

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Objective. To evaluate activity limitations 3 years after diagnosis of early rheumatoid arthritis (RA) in relation to grip force and sex. Methods. A total of 217 patients, 153 women and 64 men, with recent-onset RA were included. Activity limitations were reported using the Health Assessment Questionnaire (HAQ) and the Evaluation of Daily Activities Questionnaire (EDAQ). The relationships between activity limitations versus grip force (measured by the Grippit), walking speed, functional impairment, grip ability, pain, plasma C-reactive protein, the 28-joint disease activity score and its components, the physician's global assessment of disease activity, and sex were analyzed by partial least squares (PLS). Results. Women had significantly lower grip force and more activity limitations (HAQ and EDAQ) than men. The PLS analyses demonstrated that grip force was the strongest regressor of activity limitation, closely followed by walking speed. However, within subgroups based on grip force (group 1 ‫؍‬ grip force <114 N, group 2 ‫؍‬ 116 -206 N, group 3 ‫؍‬ 214 -321 N, group 4 ‫؍‬ grip force >328 N) and including sexes, women and men had corresponding degrees of activity limitation as reported by the HAQ and EDAQ. Conclusion. Our results indicate that the more pronounced activity limitations seen in women with RA, as compared with men, may be explained by lower grip force rather than sex.

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“…These data have been published elsewhere (6). All of the patients were receiving full secondary care intervention, and data from similar published patient cohorts indicated that during the first 12 months of specialist care, mean group upper extremity function improves (7). The outcomes considered in this analysis were all related to upper extremity function, and it was hypothesized that they would show an improvement over the followup duration.…”

Section: Introductionmentioning

confidence: 94%

Responsiveness of self‐report and therapist‐rated upper extremity structural impairment and functional outcome measures in early rheumatoid arthritis

Adams¹,

Mullee²,

Burridge³

et al. 2010

Arthritis Care & Research

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Objective. To provide a responsiveness analysis of the self-report and therapist-rated upper extremity functional outcome measures used in a rehabilitation trial. Methods. A variety of commonly used therapist-assessed and self-report structural impairment and functional outcome measures were compared for the ability to detect and measure change in wrist and hand status in an early rheumatoid arthritis population over 12 months. Responsiveness was measured using the standardized response mean (SRM) and effect size (ES).

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How does functional disability in early rheumatoid arthritis (RA) affect patients and their lives? Results of 5 years of follow‐up in 732 patients from the Early RA Study (ERAS)

Cited by 252 publications

References 22 publications

The impact on disability of initial treatment with methotrexate in patients with rheumatoid arthritis: results from the MARI study

The impact on disability of initial treatment with methotrexate in patients with rheumatoid arthritis: results from the MARI study

Activity limitation in rheumatoid arthritis correlates with reduced grip force regardless of sex: The Swedish TIRA project

Responsiveness of self‐report and therapist‐rated upper extremity structural impairment and functional outcome measures in early rheumatoid arthritis

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