Trajectories of self-reported pain-related health outcomes and longitudinal effects on medication use in rheumatoid arthritis: a prospective cohort analysis using the Australian Rheumatology Association Database (ARAD)
Authors' conclusion
In the absence of disease activity information, distinct trajectories of varying pain/health status were seen from the outset and throughout the disease course in this RA cohort. More biologic therapy modifications and greater use in anti-inflammatories, opioids and prednisolone were seen in those with poorer pain/health status, reflecting undesirable lived experience of persistent pain in RA.
Study context
- Population
- ARAD participants with rheumatoid arthritis (RA) (71% female, mean age 54 years, mean disease duration 2.3 years)
- Participants
- 988 participants
- Exposure
- Distinct trajectories of self-reported pain/health status
- Outcome
- Distinct trajectories of self-reported pain-related health status (HAQ-DI, VAS for pain, arthritis, global health, Assessment of Quality of Life utility index)
- Follow-up
- 15-year follow-up
Methodological detailslatent variable discrete mixture modelling, random effects models, 15-year follow-up
- Latent variable discrete mixture modelling
- Random effects models
- 15-year follow-up
Main finding
As reported in the abstract
Pain/health status trajectory groups
- Four, approximately equally sized, pain/health status groups identified, ranging from 'better' to 'poorer'; changes over time relatively small
- 4
Observational data: associations, not effects.
Further findings
Medication use by pain/health status
- More biologic therapy modifications with poorer pain/health status
- plinear<0.001
- Greater tendency of non-TNFi use with poorer pain/health status
- plinear<0.001
- Biologic therapy use similar between groups
- Greater use of opioids, prednisolone and NSAIDs with poorer pain/health status
Original publication
Trajectories of self-reported pain-related health outcomes and longitudinal effects on medication use in rheumatoid arthritis: a prospective cohort analysis using the Australian Rheumatology Association Database (ARAD). RMD Open. Published 28 July 2023. doi:10.
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