University of Hertfordshire Research Archive

        JavaScript is disabled for your browser. Some features of this site may not work without it.

        Browse

        All of UHRABy Issue DateAuthorsTitlesThis CollectionBy Issue DateAuthorsTitles

        Arkivum Files

        My Downloads
        View Item 
        • UHRA Home
        • University of Hertfordshire
        • Research publications
        • View Item
        • UHRA Home
        • University of Hertfordshire
        • Research publications
        • View Item

        Association between rheumatoid arthritis disease activity, progression of functional limitation and long-term risk of orthopaedic surgery : Combined analysis of two prospective cohorts supports EULAR treat to target DAS thresholds

        View/Open
        Final Published version (PDF, 738Kb)
        Author
        Nikiphorou, Elena
        Norton, Sam
        Young, Adam
        Carpenter, Lewis
        Dixey, Josh
        Walsh, David Andrew
        Kiely, Patrick
        Gough, Andrew
        Devlin, Joe
        Emery, Paul
        Waterhouse, Lynn
        James, David
        Tate, Helen
        Boys, Cathy
        Williams, Peter
        White, Dora
        Dart, Helen
        Winfield, John
        Seymour, Annie
        Williams, Richard
        Blunn, Karina
        McDowell, Jackie
        Prouse, Peter
        Andrews, Sheryl
        Wilson, Deborah
        Magliano, Malgorzata
        Perks, Ursula
        Coulson, Amanda
        Hassle, Andrew
        Kirwan, Michele
        Leone, Francesca
        Dunne, Ciaran
        Hawley, Lindsey
        Creamer, Paul
        Taylor, Julie
        Wilmott, Wendy
        Knights, Sally
        Rowland-Axe, Rebecca
        Green, Sandra
        Simmons, Dawn
        David, Joel
        Cox, Maureen
        Bukhari, Marwan
        Evans, Bronwen
        Batley, Michael
        Oram, Catherine
        ERAS and ERAN
        Attention
        2299/21741
        Abstract
        Objectives: To examine the association between disease activity in early rheumatoid arthritis (RA), functional limitation and long-term orthopaedic episodes. Methods: Health Assessment Questionnaire (HAQ) disability scores were collected from two longitudinal early RA inception cohorts in routine care; Early Rheumatoid Arthritis Study and Early Rheumatoid Arthritis Network from 1986 to 2012. The incidence of major and intermediate orthopaedic surgical episodes over 25 years was collected from national data sets. Disease activity was categorised by mean disease activity score (DAS28) annually between years 1 and 5; remission (RDAS≤2.6), low (LDAS>2.6-3.2), low-moderate (LMDAS≥3.2-4.19), high-moderate (HMDAS 4.2-5.1) and high (HDAS>5.1). Results: Data from 2045 patients were analysed. Patients in RDAS showed no HAQ progression over 5 years, whereas there was a significant relationship between rising DAS28 category and HAQ at 1 year, and the rate of HAQ progression between years 1 and 5. During 27 986 person-years follow-up, 392 intermediate and 591 major surgeries were observed. Compared with the RDAS category, there was a significantly increased cumulative incidence of intermediate surgery in HDAS (OR 2.59 CI 1.49 to 4.52) and HMDAS (OR 1.8 CI 1.05 to 3.11) categories, and for major surgery in HDAS (OR 2.48 CI 1.5 to 4.11), HMDAS (OR 2.16 CI 1.32 to 3.52) and LMDAS (OR 2.07 CI 1.28 to 3.33) categories. There was no significant difference in HAQ progression or orthopaedic episodes between RDAS and LDAS categories. Conclusions: There is an association between disease activity and both poor function and long-term orthopaedic episodes. This illustrates the far from benign consequences of persistent moderate disease activity, and supports European League Against Rheumatism treat to target recommendations to secure low disease activity or remission in all patients.
        Publication date
        2016-11-10
        Published in
        Annals of the Rheumatic Diseases
        Published version
        https://doi.org/10.1136/annrheumdis-2015-208669
        License
        http://creativecommons.org/licenses/by/4.0/
        Other links
        http://hdl.handle.net/2299/21741
        Metadata
        Show full item record
        Keep in touch

        © 2019 University of Hertfordshire

        I want to...

        • Apply for a course
        • Download a Prospectus
        • Find a job at the University
        • Make a complaint
        • Contact the Press Office

        Go to...

        • Accommodation booking
        • Your student record
        • Bayfordbury
        • KASPAR
        • UH Arts

        The small print

        • Terms of use
        • Privacy and cookies
        • Criminal Finances Act 2017
        • Modern Slavery Act 2015
        • Sitemap

        Find/Contact us

        • T: +44 (0)1707 284000
        • E: ask@herts.ac.uk
        • Where to find us
        • Parking
        • hr
        • qaa
        • stonewall
        • AMBA
        • ECU Race Charter
        • disability confident
        • AthenaSwan