Measures of activity and damage in rheumatoid arthritis: Depiction of changes and prediction of mortality over five years

Callahan, Leigh F.; Pincus, Theodore; Huston, Joseph W.; Brooks, Raye H.; Nance, E. Paul; Kaye, Jeremy J.

doi:10.1002/art.1790100606

Cited by 124 publications

(75 citation statements)

References 68 publications

(83 reference statements)

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“…Typically, disability in RA diminishes within the first year after diagnosis and start of intervention, and then either remains stable but still affected (11) or slowly worsens over time (2,12). 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).…”

Section: Introductionmentioning

confidence: 99%

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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Section: Introductionmentioning

confidence: 99%

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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“…The emergence of many early arthritis clinics (and thus, the expanded possibilities for early referral) is a likely explanation for the observation that patients present with less-active disease at the first visit. Callahan et al (22) observed that scores on a modified Health Assessment Questionnaire (M-HAQ) were unchanged over 5 years in a cohort of 100 patients from Tennessee who were monitored from [1985][1986][1987][1988][1989][1990]. This finding contrasted with those of all previous studies, which had documented significant declines in function over 5-15 years.…”

Section: Improved Morbidity In Ramentioning

confidence: 89%

“…For example, mortality over 5 years was analyzed in a series of 210 patients with RA in whom careful quantitative measurements were made at baseline in 1985 (4,22). As might be expected, poorer status at baseline (as indicated by joint counts and radiographic, laboratory, questionnaire, physical function, and demographic measures) predicted decreased survival over the next 5 years.…”

Section: Markers Of Premature Mortality In Ramentioning

confidence: 99%

“…In very recent work, Navarro-Cano et al (21) confirmed the independent contributions of RA and comorbidity to mortality. Most of this contribution comes from the widespread cardiovascular comorbidity (22). Perhaps excess mortality in RA is primarily linked to etiologies such as the effects of systemic inflammation on vascular integrity (23), and the treatments, although they improve quality of life and functioning, do not improve vascular integrity.…”

mentioning

confidence: 99%

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Making an impact on mortality in rheumatoid arthritis: Targeting cardiovascular comorbidity

Boers¹,

Dijkmans²,

Gabriel³

et al. 2004

Arthritis & Rheumatism

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100

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“…Rheumatoid arthritis (RA) prognosis is dominated by functional impairment related to joint pain, synovial inflammation, and structural damage (1,2), and by increased cardiovascular morbidity and mortality (3,4). During the past decades, modern conventional and biologic disease-modifying antirheumatic drugs (DMARDs) have been effective to various extents in controlling RA-related inflammation, preventing disease flare, the progression of structural damage (5)(6)(7)(8)(9), and thus overall improvement in RA prognosis (10).…”

Section: Introductionmentioning

confidence: 99%

Choice of second‐line disease‐modifying antirheumatic drugs after failure of methotrexate therapy for rheumatoid arthritis: A decision tree for clinical practice based on rheumatologists' preferences

Fautrel¹,

Guillemin²,

Meyer³

et al. 2009

Arthritis & Rheumatism

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Objective. To survey rheumatologists' preferences for the choice of a second-line disease-modifying antirheumatic drug (DMARD) after inadequate response with methotrexate (MTX) therapy in rheumatoid arthritis (RA).Methods. Thirty-six rheumatologists stated their preferences for RA treatment after inadequate response with MTX therapy (optimal dose at least 6 months). From the initial scenario, we derived 54 vignettes varying by rheumatoid factor or anti-cyclic citrullinated peptide antibody presence, swollen joint count, Disease Activity Score in 28 joints, and structural damage. Respondents stated their preference among 5 therapeutic options: MTX continuation, switch to another conventional DMARD, addition of another conventional DMARD, addition of anakinra, or addition of a tumor necrosis factor (TNF) blocker. Presentation by pairs yielded 10 combinations of strategies for each variant, totaling 540 vignettes; participants evaluated a random sample of 180 vignettes. Determinants of each top-ranked option were analyzed by logistic regression. The compilation of these data served to define a therapeutic algorithm. Results. The responses of 33 rheumatologists were analyzable. Therapeutic preferences corresponded to the top-ranked options. For patients with mild or moderately active RA, either a switch or step-up strategy to another conventional DMARD was top ranked. TNF blockers were preferred for RA patients with high disease activity or progressive structural damage. On the basis of these preferences, we developed a simple decision tree for use in daily clinical practice. Conclusion. Our simple, easy-to-use decision tree developed from rheumatologists' preferences for therapy after failure of MTX therapy in RA treatment may guide rheumatologists in daily practice to choose a second-line DMARD.

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Measures of activity and damage in rheumatoid arthritis: Depiction of changes and prediction of mortality over five years

Abstract: Objective. To analyze various quantitative measures of inflammatory activity and joint damage, including articular, radiographic, laboratory questionnaire, and physical function measures, in regard to changes in status in surviving patients and prediction of mortality in non-survivors over

Cited by 124 publications

References 68 publications

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

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

Making an impact on mortality in rheumatoid arthritis: Targeting cardiovascular comorbidity

Choice of second‐line disease‐modifying antirheumatic drugs after failure of methotrexate therapy for rheumatoid arthritis: A decision tree for clinical practice based on rheumatologists' preferences

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