Patient burden and joint inflammation during development of RA from arthralgia: is it similar in ACPA-positive and ACPA-negative disease?
Authors' conclusion
During RA development and CSA resolution, ACPA-positive CSA patients have lower patient burden but more subclinical joint inflammation than ACPA-negative CSA patients.
Study context
- Population
- Patients with clinically suspect arthralgia (CSA), followed during progression to inflammatory arthritis (IA) or CSA resolution136 developed IA
- Participants
- 845 patients
- Exposure
- ACPA-positive vs ACPA-negative CSA
- Outcome
- Course of patient burden (pain, morning stiffness, fatigue, functional disabilities, presenteeism) and subclinical joint inflammation (MRI) during progression to IA or CSA resolution
Methodological detailslinear and Poisson mixed models, serial 1.5T MRI of hands and feet, median follow-up 24 months, 355/505 patients had resolution of CSA, patient burden assessed at baseline, 4, 12 and 24 months and at IA development
- Linear and Poisson mixed models
- Serial 1.5T MRI of hands and feet
- Median follow-up 24 months
- 355/505 patients had resolution of CSA
- Patient burden assessed at baseline, 4, 12 and 24 months and at IA development
Main finding
As reported in the abstract
ACPA-positive vs ACPA-negativeIncidence rate ratio (95% CI)P value
Subclinical joint inflammation increase during development of IA
1.52(0.94–2.47)
P = 0.089Subclinical joint inflammation over time in patients achieving CSA resolution
1.52(1.07–2.15)
P = 0.018Observational data: associations, not effects.
Further findings
ρ
| Outcome | ACPA-positive | ACPA-negative |
|---|---|---|
| Correlation between changes in functional disabilities and subclinical joint inflammation during progression to IA | 0.29 | 0.12 |
Correlation between changes in functional disabilities and subclinical joint inflammation during progression to IA
- Correlations weak but consistently higher in ACPA-positive than ACPA-negative disease
Original publication
Patient burden and joint inflammation during development of RA from arthralgia: is it similar in ACPA-positive and ACPA-negative disease? Rheumatology (Oxford). Published 23 January 2024. doi:10.
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