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dc.contributor.authorNikiphorou, Elena
dc.contributor.authorNorton, Sam
dc.contributor.authorYoung, Adam
dc.contributor.authorCarpenter, Lewis
dc.contributor.authorDixey, Josh
dc.contributor.authorWalsh, David Andrew
dc.contributor.authorKiely, Patrick
dc.contributor.authorGough, Andrew
dc.contributor.authorDevlin, Joe
dc.contributor.authorEmery, Paul
dc.contributor.authorWaterhouse, Lynn
dc.contributor.authorJames, David
dc.contributor.authorTate, Helen
dc.contributor.authorBoys, Cathy
dc.contributor.authorWilliams, Peter
dc.contributor.authorWhite, Dora
dc.contributor.authorDart, Helen
dc.contributor.authorWinfield, John
dc.contributor.authorSeymour, Annie
dc.contributor.authorWilliams, Richard
dc.contributor.authorBlunn, Karina
dc.contributor.authorMcDowell, Jackie
dc.contributor.authorProuse, Peter
dc.contributor.authorAndrews, Sheryl
dc.contributor.authorWilson, Deborah
dc.contributor.authorMagliano, Malgorzata
dc.contributor.authorPerks, Ursula
dc.contributor.authorCoulson, Amanda
dc.contributor.authorHassle, Andrew
dc.contributor.authorKirwan, Michele
dc.contributor.authorLeone, Francesca
dc.contributor.authorDunne, Ciaran
dc.contributor.authorHawley, Lindsey
dc.contributor.authorCreamer, Paul
dc.contributor.authorTaylor, Julie
dc.contributor.authorWilmott, Wendy
dc.contributor.authorKnights, Sally
dc.contributor.authorRowland-Axe, Rebecca
dc.contributor.authorGreen, Sandra
dc.contributor.authorSimmons, Dawn
dc.contributor.authorDavid, Joel
dc.contributor.authorCox, Maureen
dc.contributor.authorBukhari, Marwan
dc.contributor.authorEvans, Bronwen
dc.contributor.authorBatley, Michael
dc.contributor.authorOram, Catherine
dc.contributor.authorERAS and ERAN
dc.date.accessioned2019-10-16T00:07:01Z
dc.date.available2019-10-16T00:07:01Z
dc.date.issued2016-11-10
dc.identifier.citationNikiphorou , E , Norton , S , Young , A , Carpenter , L , Dixey , J , Walsh , D A , Kiely , P , Gough , A , Devlin , J , Emery , P , Waterhouse , L , James , D , Tate , H , Boys , C , Williams , P , White , D , Dart , H , Winfield , J , Seymour , A , Williams , R , Blunn , K , McDowell , J , Prouse , P , Andrews , S , Wilson , D , Magliano , M , Perks , U , Coulson , A , Hassle , A , Kirwan , M , Leone , F , Dunne , C , Hawley , L , Creamer , P , Taylor , J , Wilmott , W , Knights , S , Rowland-Axe , R , Green , S , Simmons , D , David , J , Cox , M , Bukhari , M , Evans , B , Batley , M , Oram , C & ERAS and ERAN 2016 , ' 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 ' , Annals of the Rheumatic Diseases , vol. 75 , no. 12 , pp. 2080-2086 . https://doi.org/10.1136/annrheumdis-2015-208669
dc.identifier.issn0003-4967
dc.identifier.otherPURE: 13380526
dc.identifier.otherPURE UUID: 222f2c62-1fcc-4d90-8da3-729bc26580b8
dc.identifier.otherScopus: 84962256188
dc.identifier.otherPubMed: 26979104
dc.identifier.urihttp://hdl.handle.net/2299/21741
dc.description.abstractObjectives: 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.en
dc.format.extent7
dc.language.isoeng
dc.relation.ispartofAnnals of the Rheumatic Diseases
dc.rightsOpen
dc.subjectDisease Activity
dc.subjectDMARDs (biologic)
dc.subjectDMARDs (synthetic)
dc.subjectRheumatoid Arthritis
dc.subjectTreatment
dc.subjectRheumatology
dc.subjectImmunology and Allergy
dc.subjectImmunology
dc.subjectBiochemistry, Genetics and Molecular Biology(all)
dc.titleAssociation 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 thresholdsen
dc.contributor.institutionDepartment of Psychology
dc.contributor.institutionCentre for Lifespan and Chronic Illness Research
dc.contributor.institutionUniversity of Hertfordshire
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=84962256188&partnerID=8YFLogxK
dc.description.versiontypeFinal Published version
dcterms.dateAccepted2016-11-10
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.1136/annrheumdis-2015-208669
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue
herts.rights.accesstypeOpen


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