Charis F Meng, Yvonne C Lee, Orit Schieir, Marie-France Valois, Margaret A Butler, Gilles Boire, Glen Hazlewood, Hugues Allard-Chamard, Carol Hitchon, Kuriya Bindee, Diane Tin, Carter Thorne, Louis Bessette, Janet Pope, Susan J Bartlett, Vivian P Bykerk
{"title":"前瞻性真实世界早期类风湿关节炎队列中早期类风湿关节炎诊断时非关节疼痛的特征、治疗第一年的演变以及对缓解的影响。","authors":"Charis F Meng, Yvonne C Lee, Orit Schieir, Marie-France Valois, Margaret A Butler, Gilles Boire, Glen Hazlewood, Hugues Allard-Chamard, Carol Hitchon, Kuriya Bindee, Diane Tin, Carter Thorne, Louis Bessette, Janet Pope, Susan J Bartlett, Vivian P Bykerk","doi":"10.1002/art.43049","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To characterize non-articular pain (NAP) at early RA diagnosis, the evolution over the first year of treatment, associations with active RA inflammation and impact on remission.</p><p><strong>Methods: </strong>This real-world, longitudinal multi-center cohort study followed participants with active early RA (symptoms<1 year, CDAI>2.8,) enrolled between 1/2017 and 1/2022, and who completed a body pain diagram (BPD) over 1-year. Participants were grouped by prespecified definitions of NAP: 1) none 2) regional or 3) widespread. Rheumatologists performed joint counts. Descriptive statistics summarized the frequency and evolution of NAP patterns over 1-year. Chi-square tests compared the proportions of tender and/or swollen joints by presence of pain in each NAP section. Multi-adjusted GEE regression models estimated associations of NAP patterns with remission outcomes.</p><p><strong>Results: </strong>Participants (N=392) were 70% female, mean(Sd) age of 56(14) years and mean symptoms duration of 5.1(2.7) months. Over half reported NAP at baseline with most (73%) presenting with regional NAP. Common patterns of regional NAP were axial (40%) and pain in upper quadrants (17%). 43% of those with regional NAP persisted or worsened over 1-year, whereas 73% of those with widespread NAP resolved or improved. Joint inflammation was more frequently reported in areas with NAP vs areas without NAP. Regional and widespread NAP were associated with lower odds of reaching CDAI remission (adjusted OR [95%CI]):0.42[0.26 to 0.70] and 0.30[0.12 to 0.74], respectively.</p><p><strong>Conclusion: </strong>Regional NAP is common and persistent in early RA and impacts remission. RA activity may contribute to NAP. More attention to NAP in RA care is warranted.</p>","PeriodicalId":129,"journal":{"name":"Arthritis & Rheumatology","volume":" ","pages":""},"PeriodicalIF":11.4000,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Characterizing Non-Articular Pain at Early Rheumatoid Arthritis Diagnosis, Evolution over the First year of Treatment and Impact on Remission in a Prospective Real-World Early Rheumatoid Arthritis Cohort.\",\"authors\":\"Charis F Meng, Yvonne C Lee, Orit Schieir, Marie-France Valois, Margaret A Butler, Gilles Boire, Glen Hazlewood, Hugues Allard-Chamard, Carol Hitchon, Kuriya Bindee, Diane Tin, Carter Thorne, Louis Bessette, Janet Pope, Susan J Bartlett, Vivian P Bykerk\",\"doi\":\"10.1002/art.43049\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To characterize non-articular pain (NAP) at early RA diagnosis, the evolution over the first year of treatment, associations with active RA inflammation and impact on remission.</p><p><strong>Methods: </strong>This real-world, longitudinal multi-center cohort study followed participants with active early RA (symptoms<1 year, CDAI>2.8,) enrolled between 1/2017 and 1/2022, and who completed a body pain diagram (BPD) over 1-year. Participants were grouped by prespecified definitions of NAP: 1) none 2) regional or 3) widespread. Rheumatologists performed joint counts. Descriptive statistics summarized the frequency and evolution of NAP patterns over 1-year. Chi-square tests compared the proportions of tender and/or swollen joints by presence of pain in each NAP section. Multi-adjusted GEE regression models estimated associations of NAP patterns with remission outcomes.</p><p><strong>Results: </strong>Participants (N=392) were 70% female, mean(Sd) age of 56(14) years and mean symptoms duration of 5.1(2.7) months. Over half reported NAP at baseline with most (73%) presenting with regional NAP. Common patterns of regional NAP were axial (40%) and pain in upper quadrants (17%). 43% of those with regional NAP persisted or worsened over 1-year, whereas 73% of those with widespread NAP resolved or improved. Joint inflammation was more frequently reported in areas with NAP vs areas without NAP. Regional and widespread NAP were associated with lower odds of reaching CDAI remission (adjusted OR [95%CI]):0.42[0.26 to 0.70] and 0.30[0.12 to 0.74], respectively.</p><p><strong>Conclusion: </strong>Regional NAP is common and persistent in early RA and impacts remission. RA activity may contribute to NAP. More attention to NAP in RA care is warranted.</p>\",\"PeriodicalId\":129,\"journal\":{\"name\":\"Arthritis & Rheumatology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":11.4000,\"publicationDate\":\"2024-10-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arthritis & Rheumatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/art.43049\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthritis & Rheumatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/art.43049","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的描述早期RA诊断时的非关节疼痛(NAP)、治疗第一年的演变、与活动性RA炎症的关联以及对缓解的影响:这项真实世界的纵向多中心队列研究对 2017 年 1 月 1 日至 2022 年 1 月 1 日期间入组的活动性早期 RA 患者(症状为 2.8,)进行了跟踪调查,这些患者在一年内完成了身体疼痛图(BPD)的绘制。参与者按预先指定的 NAP 定义分组:1)无 2)区域性或 3)广泛性。风湿病学家进行了关节计数。描述性统计总结了一年内非正常疼痛模式的频率和演变情况。卡方检验比较了每个 NAP 部分中出现疼痛的关节触痛和/或肿胀的比例。多重调整 GEE 回归模型估计了 NAP 模式与缓解结果的关联:参与者(392 人)中 70% 为女性,平均(Sd)年龄为 56(14)岁,平均症状持续时间为 5.1(2.7)个月。超过半数的人在基线时报告了 NAP,其中大多数(73%)表现为区域性 NAP。区域性 NAP 的常见模式为轴向疼痛(40%)和上象限疼痛(17%)。43% 的区域性 NAP 在 1 年内持续存在或恶化,而 73% 的广泛性 NAP 在 1 年内缓解或改善。据报告,有非典型肺炎的地区与没有非典型肺炎的地区相比,关节炎症的发生率更高。区域性和广泛性NAP与较低的CDAI缓解几率相关(调整后OR[95%CI]):分别为0.42[0.26至0.70]和0.30[0.12至0.74]:结论:区域性NAP在早期RA中常见且持续存在,并影响缓解。RA活动可能会导致NAP。在 RA 护理中应更多关注 NAP。
Characterizing Non-Articular Pain at Early Rheumatoid Arthritis Diagnosis, Evolution over the First year of Treatment and Impact on Remission in a Prospective Real-World Early Rheumatoid Arthritis Cohort.
Objective: To characterize non-articular pain (NAP) at early RA diagnosis, the evolution over the first year of treatment, associations with active RA inflammation and impact on remission.
Methods: This real-world, longitudinal multi-center cohort study followed participants with active early RA (symptoms<1 year, CDAI>2.8,) enrolled between 1/2017 and 1/2022, and who completed a body pain diagram (BPD) over 1-year. Participants were grouped by prespecified definitions of NAP: 1) none 2) regional or 3) widespread. Rheumatologists performed joint counts. Descriptive statistics summarized the frequency and evolution of NAP patterns over 1-year. Chi-square tests compared the proportions of tender and/or swollen joints by presence of pain in each NAP section. Multi-adjusted GEE regression models estimated associations of NAP patterns with remission outcomes.
Results: Participants (N=392) were 70% female, mean(Sd) age of 56(14) years and mean symptoms duration of 5.1(2.7) months. Over half reported NAP at baseline with most (73%) presenting with regional NAP. Common patterns of regional NAP were axial (40%) and pain in upper quadrants (17%). 43% of those with regional NAP persisted or worsened over 1-year, whereas 73% of those with widespread NAP resolved or improved. Joint inflammation was more frequently reported in areas with NAP vs areas without NAP. Regional and widespread NAP were associated with lower odds of reaching CDAI remission (adjusted OR [95%CI]):0.42[0.26 to 0.70] and 0.30[0.12 to 0.74], respectively.
Conclusion: Regional NAP is common and persistent in early RA and impacts remission. RA activity may contribute to NAP. More attention to NAP in RA care is warranted.
期刊介绍:
Arthritis & Rheumatology is the official journal of the American College of Rheumatology and focuses on the natural history, pathophysiology, treatment, and outcome of rheumatic diseases. It is a peer-reviewed publication that aims to provide the highest quality basic and clinical research in this field. The journal covers a wide range of investigative areas and also includes review articles, editorials, and educational material for researchers and clinicians. Being recognized as a leading research journal in rheumatology, Arthritis & Rheumatology serves the global community of rheumatology investigators and clinicians.