Patterns of comorbidities differentially affect long-term functional evolution and disease activity in patients with ‘difficult to treat’ rheumatoid arthritis
Authors' conclusion
D2T patients represent a heterogeneous group in terms of long-term disease course. Mental-health/pain-related illnesses as well as metabolic diseases contribute to long-term adverse outcomes
Study context
- Population
- Patients with RA from a prospective single-centre cohort; Difficult to treat (D2T) defined by the EULAR definition251 D2T
- Participants
- 1,264 patients
- Outcome
- Long-term evolution of functional status (mHAQ) and disease activity (DAS28) in D2T RA, and contributing factors
Methodological detailssingle-centre, latent-class trajectory analysis, linear mixed models
- Single-centre
- Latent-class trajectory analysis
- Linear mixed models
Main finding
As reported in the abstract
- Identified as D2T
- 251 out of 1264 patients (19.9%)
- Functional status (modified Health Assessment Questionnaire (mHAQ)) trajectories: four groups
- 4
- Stable, mildly compromised mHAQ (mean 0.41)
- 18.2%
- Gradual mHAQ improvement (1.21-0.87)
- 39.9%
- Disease activity trajectories: four distinct groups
- 4
- 'Mental-health and pain-related illnesses' cluster, contribution to mHAQ worsening
- p<0.0001
- 'Metabolic diseases' cluster, contribution to mHAQ worsening
- p<0.0001
- 'Mental-health and pain-related illnesses' cluster, contribution to DAS28 evolution
- p<0.0001
- 'Metabolic diseases' cluster, contribution to DAS28 evolution
- p=0.018
Observational data: associations, not effects.
Further findings
Predictors of becoming D2T
- Younger age, FM, OA, DAS28-ESR at first b/tsDMARD initiation and failure to reduce DAS28-ESR within the first 6 months of b/tsDMARD therapy were significant predictors
Original publication
Patterns of comorbidities differentially affect long-term functional evolution and disease activity in patients with ‘difficult to treat’ rheumatoid arthritis. RMD Open. Published 19 January 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →