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dc.contributor.authorNikiphorou, Elena
dc.contributor.authorNorton, Sam
dc.contributor.authorCarpenter, Lewis
dc.contributor.authorWelsh, David
dc.contributor.authorCreamer, Paul
dc.contributor.authorDixey, Josh
dc.contributor.authorYoung, Adam
dc.contributor.authorKiely, Patrick
dc.date.accessioned2019-10-10T00:08:47Z
dc.date.available2019-10-10T00:08:47Z
dc.date.issued2019-10-03
dc.identifier.citationNikiphorou , E , Norton , S , Carpenter , L , Welsh , D , Creamer , P , Dixey , J , Young , A & Kiely , P 2019 , ' Remission vs low disease activity: function, quality of life and structural outcomes in the Early Rheumatoid Arthritis Study and Network ' , Rheumatology , vol. 59 , no. 6 , pp. 1272–1280 . https://doi.org/10.1093/rheumatology/kez461
dc.identifier.issn1462-0324
dc.identifier.otherPURE: 17527010
dc.identifier.otherPURE UUID: 6b45e77a-8975-4e14-bd8c-c7824bf7fffb
dc.identifier.otherScopus: 85085533546
dc.identifier.urihttp://hdl.handle.net/2299/21729
dc.description.abstractObjectives To examine associations between function, quality of life and structural outcomes in patients achieving remission vs low disease activity in early RA. Methods Demographic, clinical and radiographic variables were collected at baseline and then annually from the Early Rheumatoid Arthritis Study (ERAS) and Early Rheumatoid Arthritis Network (ERAN) inception cohorts in routine care from 1986 to 2012. Disease activity was categorized: mean DAS28 score between years 1 and 5: remission [mean remission DAS (mRDAS) <2.6] or low [mean low DAS (mLDAS) 2.6–3.2]; sustained low/remission DAS28 (sLDAS/sRDAS) at years 1 and 2; and sustained Boolean remission (sBR) at years 1 and 2. Changes in HAQ and Short Form 36 Health Survey Questionnaire [SF-36; physical (PCS) and mental (MCS) component score]) and total Sharp van der Heijde (SvdH) scores for each disease activity category were modelled using multi-level models. Covariates included year of onset, age, gender and DMARD use at first visit. Results Of 2701 patients, 562 (21%) were categorized mRDAS, 330 (12%) mLDAS, 279 (10%) sRDAS, 203 (7.5%) sLDAS and 93 (3%) sBR. Patients categorized as mRDAS had increasingly divergent improved HAQ, SF-36 PCS, MCS and total SvdH scores compared with mLDAS (P-values 0.001 to <0.0001, all time points). Patients categorized as sRDAS had better HAQ, SF-36 PCS and MCS scores (P-values 0.05 to <0.0001, all time points) and SvdH scores (P = 0.05, years 3–5) over sLDAS. sBR was associated with better HAQ, and SF-36 PCS and MCS scores over sLDAS (P-values 0.002 to <0.0001, all time points). Conclusion These findings from routine care support ACR/EULAR guidelines that remission is a preferable goal over low disease activity in early RA.en
dc.language.isoeng
dc.relation.ispartofRheumatology
dc.rightsOpen
dc.titleRemission vs low disease activity: function, quality of life and structural outcomes in the Early Rheumatoid Arthritis Study and Networken
dc.contributor.institutionDepartment of Clinical and Pharmaceutical Sciences
dc.contributor.institutionCentre for Health Services and Clinical Research
dc.contributor.institutionBasic and Clinical Science Unit
dc.contributor.institutionSchool of Life and Medical Sciences
dc.description.statusPeer reviewed
dc.relation.schoolSchool of Life and Medical Sciences
dc.description.versiontypeFinal Published version
dcterms.dateAccepted2019-10-03
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.1093/rheumatology/kez461
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by-nc/4.0/
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue
herts.rights.accesstypeOpen


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