One in five patients with rapidly and persistently controlled early rheumatoid arthritis report poor well-being after 1 year of treatment

Kristien Van der Elst, Patrick Verschueren, Diederik De Cock, An De Groef, Veerle Stouten, Sofia Pazmino, Johanna Vriezekolk, Johan Joly, Philip Moons, René Westhovens

Onderzoeksoutput: Articlepeer review

24 Citaten (Scopus)

Samenvatting

Objectives To identify and characterise a subgroup of patients with early rheumatoid arthritis (RA) reporting not feeling well 1 year after treatment initiation despite achieving optimal disease control according to current treatment standards. Methods This observational study included participants of the Care in early RA trial with a rapid and sustained response (DAS28CRP<2.6) from week 16 until year 1 after starting the first RA treatment. Feeling well was assessed at year 1, using five patient-reported outcomes (PROs): pain, fatigue, physical functioning, RA-related quality of life and sleep quality. K-means clustering assigned patients to a cluster based on these PROs. Cohen's d effect size estimated cluster differences at treatment initiation and week 16, for the five clustering PROs, coping behaviour, illness perceptions and social support. Results Analyses revealed three clusters. Of 140 patients, 77.9% were assigned to the concordant to disease activity' cluster, 9.3% to the dominant fatigue' cluster and 12.9% to the dominant pain and fatigue' cluster. Large differences in pain and fatigue reporting were found at week 16 when comparing the concordant' with the dominant pain and fatigue' or the dominant fatigue' cluster. Small differences in reporting were found for the other PROs. Illness perceptions and coping style also differed in the concordant' cluster. Conclusions Although most patients reported PRO scores in concordance with their well-controlled disease activity, one in five persistent treatment responders reported not feeling well at year 1. These patients reported higher pain and fatigue, and different illness perceptions and coping strategies early in the disease course.

Originele taal-2English
Artikelnummere001146
TijdschriftRMD open
Volume6
Nummer van het tijdschrift1
DOI's
StatusPublished - 5 mei 2020

Bibliografische nota

Funding Information:
The CareRA trial (EudraCT number: 2008-007225-39) was funded by a Flemish governmental grant (Agency for Innovation by Science and Technology [IWT]). Patrick Verschueren holds the Pfizer chair for early rheumatoid arthritis management at the KU Leuven.

Funding Information:
The CareRA trial (EudraCT number: 2008-007225-39) was funded by a Flemish governmental grant (Agency for Innovation by Science and Technology [IWT]). Patrick Verschueren holds the Pfizer chair for early rheumatoid arthritis management at the KU Leuven.

Publisher Copyright:
© © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

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