Persistently different patterns of patient’s global assessment of health in rheumatoid arthritis are associated with pain and impaired function more than with inflammation: an inception cohort study over 15 years
Authors' conclusion
Persistently higher PGA levels in RA were mostly related to pain and disability.
Study context
- Population
- Patients with early rheumatoid arthritis (RA) in the BARFOT cohort, included 1991–2006included 1991–2006
- Participants
- 2,238 patients
- Exposure
- Low vs medium vs high PGA trajectories over the first 2 years
- Outcome
- PGA in relation to inflammation, pain and disability
- Follow-up
- 15 years
Methodological details15-year follow-up, hierarchical agglomerative clustering (Ward's method), multivariate linear regression and mixed models
- 15-year follow-up
- Hierarchical agglomerative clustering (Ward's method)
- Multivariate linear regression and mixed models
Main finding
As reported in the abstract
Determinants of PGA levels from baseline over 15 years (adjusted R2)
- Visual analogue scale (VAS) pain, adjusted R2 up to
- 77%
- Health Assessment Questionnaire (HAQ) score, adjusted R2 up to
- 41%
- DAS28-3, adjusted R2 up to
- 27%
- Tender joint count, adjusted R2 up to
- 26%
Observational data: associations, not effects.
Further findings
Baseline characteristics
- Low PGA less often women, lower BMI, lower inflammatory variables, VAS pain and HAQ than higher PGA groups
- After adjustment, smoking and anti-CCP status differentiated low vs high PGA
Outcomes over follow-up
- All PGA groups improved in first year, most in low PGA
- Fewer in high PGA achieved remission, independent of criteria
- Outcomes consistently different between PGA groups from 6 months onwards
- Similar PGA patterns for inclusion before and after 1999
Original publication
Persistently different patterns of patient’s global assessment of health in rheumatoid arthritis are associated with pain and impaired function more than with inflammation: an inception cohort study over 15 years. RMD Open. Published 21 January 2025. doi:10.
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