Uncovering the heterogeneity of care trajectories leading up to a rheumatoid arthritis diagnosis: a Swedish 10-year study
Authors' conclusion
Individuals with new-onset RA can be grouped into clusters, each with its own signature in terms of pre-RA healthcare resource utilisation and deviation from the expected years before the RA diagnosis.
Study context
- Population
- Patients with first-ever seropositive rheumatoid arthritis (RA) diagnosis 2016–2020 in the Swedish nationwide multiregister system, with matched general population controlsseropositive RA
- Participants
- 6,824 patients
- Exposure
- Patients with new RA vs matched general population controls
- RAn = 6,824
- Outcome
- Types of care trajectories (pattern of healthcare use across 9 healthcare components) leading to RA diagnosis, and deviation from the general population
- Follow-up
- 10 years preceding the index date
Methodological detailsnationwide multiregister, matched general population controls, group-based multitrajectory modelling
- Nationwide multiregister
- Matched general population controls
- Group-based multitrajectory modelling
Main finding
As reported in the abstract
Care trajectory types before RA diagnosis · 10 years before index date
- (i) Healthy: low healthcare use across all care components
- 60%
- (ii) High sick leave: no musculoskeletal (MSK) or infection-related inpatient care but high sick leave
- 18%
- (iii) Chronic pain: high use of analgesics with frequent MSK-related inpatient care
- 10%
- (iv) High infection: frequent infection-related inpatient use
- 9%
- (v) High burden: overall high use of healthcare
- 3%
Observational data: associations, not effects.
Further findings
Earliest deviation from expected trajectories in the general population · before index date
Years
- Types 1, 3, 5
- 10
- Type 4
- 3
- Type 2
- 2
Original publication
Uncovering the heterogeneity of care trajectories leading up to a rheumatoid arthritis diagnosis: a Swedish 10-year study. Ann Rheum Dis. Published 24 June 2026. doi:10.
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