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dc.contributor.authorMcWilliams, Daniel F.
dc.contributor.authorFerguson, Eamonn
dc.contributor.authorYoung, Adam
dc.contributor.authorKiely, Patrick D.W.
dc.contributor.authorWalsh, David A.
dc.date.accessioned2019-05-02T14:05:47Z
dc.date.available2019-05-02T14:05:47Z
dc.date.issued2016-12-13
dc.identifier.citationMcWilliams , D F , Ferguson , E , Young , A , Kiely , P D W & Walsh , D A 2016 , ' Discordant inflammation and pain in early and established rheumatoid arthritis : Latent Class Analysis of Early Rheumatoid Arthritis Network and British Society for Rheumatology Biologics Register data ' , Arthritis Research and Therapy , vol. 18 , no. 1 , 295 . https://doi.org/10.1186/s13075-016-1186-8
dc.identifier.issn1478-6354
dc.identifier.otherPURE: 13380920
dc.identifier.otherPURE UUID: c089e06a-2285-4486-b6ae-b80d4b62f5c4
dc.identifier.otherScopus: 85003707711
dc.identifier.otherPubMed: 27964757
dc.identifier.urihttp://hdl.handle.net/2299/21312
dc.description© The Author(s). 2016
dc.description.abstractBackground: Rheumatoid arthritis (RA) disease activity is often measured using the 28-joint Disease Activity Score (DAS28). We aimed to identify and independently verify subgroups of people with RA that may be discordant with respect to self-reported and objective disease state, with potentially different clinical needs. Methods: Data were derived from three cohorts: (1) the Early Rheumatoid Arthritis Network (ERAN) and the British Society for Rheumatology Biologics Register (BSRBR), (2) those commencing tumour necrosis factor (TNF)-α inhibitors and (3) those using non-biologic drugs. In latent class analysis, we used variables related to pain, central pain mechanisms or inflammation (pain, vitality, mental health, erythrocyte sedimentation rate, swollen joint count, tender joint count, visual analogue scale of general health). Clinically relevant outcomes were examined. Results: Five, four and four latent classes were found in the ERAN, BSRBR TNF inhibitor and non-biologic cohorts, respectively. The proportions of people assigned with >80% probability into latent classes were 76%, 58% and 72% in the ERAN, TNF inhibitor and non-biologic cohorts, respectively. The latent classes displayed either concordance between measures indicative of mild, moderate or severe disease activity; discordantly worse patient-reported measures despite less markedly elevated inflammation; or discordantly less severe patient-reported measures despite elevated inflammation. Latent classes with discordantly worse patient-reported measures represented 12%, 40% and 21% of the ERAN, TNF inhibitor and non-biologic cohorts, respectively; contained more females; and showed worse function. In those latent classes with worse scores at baseline, DAS28 and function improved over 1year (p<0.001 for all comparisons), and scores differed less at follow-up than at baseline. Conclusions: Discordant latent classes can be identified in people with RA, and these findings are robust across three cohorts with varying disease duration and activity. These findings could be used to identify a sizeable subgroup of people with RA who might gain added benefit from pain management strategies.en
dc.format.extent12
dc.language.isoeng
dc.relation.ispartofArthritis Research and Therapy
dc.subjectInflammation
dc.subjectLatent class analysis
dc.subjectPain
dc.subjectRheumatoid arthritis
dc.subjectRheumatology
dc.subjectImmunology and Allergy
dc.subjectImmunology
dc.titleDiscordant inflammation and pain in early and established rheumatoid arthritis : Latent Class Analysis of Early Rheumatoid Arthritis Network and British Society for Rheumatology Biologics Register dataen
dc.contributor.institutionSchool of Life and Medical Sciences
dc.contributor.institutionCentre for Health Services and Clinical Research
dc.contributor.institutionBasic and Clinical Science Unit
dc.description.statusPeer reviewed
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85003707711&partnerID=8YFLogxK
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.1186/s13075-016-1186-8
rioxxterms.typeOther
herts.preservation.rarelyaccessedtrue


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