The impact of patients reported flares on functional impairment in rheumatoid arthritis patients with low-disease activity: A prospective cohort study based on the AMBRA trial

Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

Resumé

Background: Flares - episodes of worsening in disease activity - are common features in patients with rheumatoid arthritis (RA), even in remission or in low disease activity state. There are different definitions of flare. It is unknown whether patient reported flares lead to suboptimal long-term outcomes. Objectives: To investigate whether transient patient reported flares can influence functional disability in patients with established low active RA. Methods: Out of 287 patients from the AMBRA trial (1), 268 RA patients with low disease activity (DAS28CRP MCID of 0.22) was compared across three groups and the association between flare phenotype and functional outcome was analyzed by logistic regression. Results: 70% were female, median age [IQR] was 63 years [55;70], 73% were rheumatoid factor positive, 71% anti-CCP positive and all had established RA (median [IQR] 7 years [4;13]). Based on the flare questionnaire three groups were distinguished: No-flares group (n=77), transient flares group (n=141) and patients with persistent joint complaints (n=50). Worsening in functional capacity (HAQ>0.22) was seen in 13%, 21% and 40% of patients with no flares, with transient flares and those with persistent joint complaints, respectively (p=0.0015). Compared to the reference group (no flares) worsening in functional capacity was potentially related to "flare phenotype": OR 1.81 (95%CI: 0.83-3.94, p=0.134) for the transient flare status, and statistically significantly associated with persistent joint complaints OR 2.01 (1.22-3.31, p=0.006). Conclusions: RA patients with established low disease activity, who self-report persistent joint complaints have worse functional outcome compared to patients with transient flares and without flares.
OriginalsprogEngelsk
ArtikelnummerAB0255
TidsskriftAnnals of the Rheumatic Diseases
Vol/bind74
Udgave nummerS2
Sider (fra-til)977
Antal sider1
ISSN0003-4967
StatusUdgivet - 2015
BegivenhedEULAR 2015: Annual European Congress of Rheumatology - Fiera Roma, Rom, Italien
Varighed: 10. jun. 201513. jun. 2015

Konference

KonferenceEULAR 2015
LokationFiera Roma
LandItalien
ByRom
Periode10/06/201513/06/2015

Emneord

  • *patient *European *human *disease activity *rheumatoid arthritis *rheumatic disease *cohort analysis *rheumatology *functional disease functional status phenotype logistic regression analysis Health Assessment Questionnaire recall disability remission self report questionnaire female rheumatoid factor

Citer dette

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title = "The impact of patients reported flares on functional impairment in rheumatoid arthritis patients with low-disease activity: A prospective cohort study based on the AMBRA trial",
abstract = "Background: Flares - episodes of worsening in disease activity - are common features in patients with rheumatoid arthritis (RA), even in remission or in low disease activity state. There are different definitions of flare. It is unknown whether patient reported flares lead to suboptimal long-term outcomes. Objectives: To investigate whether transient patient reported flares can influence functional disability in patients with established low active RA. Methods: Out of 287 patients from the AMBRA trial (1), 268 RA patients with low disease activity (DAS28CRP MCID of 0.22) was compared across three groups and the association between flare phenotype and functional outcome was analyzed by logistic regression. Results: 70{\%} were female, median age [IQR] was 63 years [55;70], 73{\%} were rheumatoid factor positive, 71{\%} anti-CCP positive and all had established RA (median [IQR] 7 years [4;13]). Based on the flare questionnaire three groups were distinguished: No-flares group (n=77), transient flares group (n=141) and patients with persistent joint complaints (n=50). Worsening in functional capacity (HAQ>0.22) was seen in 13{\%}, 21{\%} and 40{\%} of patients with no flares, with transient flares and those with persistent joint complaints, respectively (p=0.0015). Compared to the reference group (no flares) worsening in functional capacity was potentially related to {"}flare phenotype{"}: OR 1.81 (95{\%}CI: 0.83-3.94, p=0.134) for the transient flare status, and statistically significantly associated with persistent joint complaints OR 2.01 (1.22-3.31, p=0.006). Conclusions: RA patients with established low disease activity, who self-report persistent joint complaints have worse functional outcome compared to patients with transient flares and without flares.",
keywords = "*patient *European *human *disease activity *rheumatoid arthritis *rheumatic disease *cohort analysis *rheumatology *functional disease functional status phenotype logistic regression analysis Health Assessment Questionnaire recall disability remission self report questionnaire female rheumatoid factor",
author = "K{\"u}ttel, {Dorota Paulina} and R. Christensen and J. Primdahl and K. Horslev-Petersen",
year = "2015",
language = "English",
volume = "74",
pages = "977",
journal = "Annals of the Rheumatic Diseases",
issn = "0003-4967",
publisher = "B M J Group",
number = "S2",

}

TY - ABST

T1 - The impact of patients reported flares on functional impairment in rheumatoid arthritis patients with low-disease activity

T2 - A prospective cohort study based on the AMBRA trial

AU - Küttel, Dorota Paulina

AU - Christensen, R.

AU - Primdahl, J.

AU - Horslev-Petersen, K.

PY - 2015

Y1 - 2015

N2 - Background: Flares - episodes of worsening in disease activity - are common features in patients with rheumatoid arthritis (RA), even in remission or in low disease activity state. There are different definitions of flare. It is unknown whether patient reported flares lead to suboptimal long-term outcomes. Objectives: To investigate whether transient patient reported flares can influence functional disability in patients with established low active RA. Methods: Out of 287 patients from the AMBRA trial (1), 268 RA patients with low disease activity (DAS28CRP MCID of 0.22) was compared across three groups and the association between flare phenotype and functional outcome was analyzed by logistic regression. Results: 70% were female, median age [IQR] was 63 years [55;70], 73% were rheumatoid factor positive, 71% anti-CCP positive and all had established RA (median [IQR] 7 years [4;13]). Based on the flare questionnaire three groups were distinguished: No-flares group (n=77), transient flares group (n=141) and patients with persistent joint complaints (n=50). Worsening in functional capacity (HAQ>0.22) was seen in 13%, 21% and 40% of patients with no flares, with transient flares and those with persistent joint complaints, respectively (p=0.0015). Compared to the reference group (no flares) worsening in functional capacity was potentially related to "flare phenotype": OR 1.81 (95%CI: 0.83-3.94, p=0.134) for the transient flare status, and statistically significantly associated with persistent joint complaints OR 2.01 (1.22-3.31, p=0.006). Conclusions: RA patients with established low disease activity, who self-report persistent joint complaints have worse functional outcome compared to patients with transient flares and without flares.

AB - Background: Flares - episodes of worsening in disease activity - are common features in patients with rheumatoid arthritis (RA), even in remission or in low disease activity state. There are different definitions of flare. It is unknown whether patient reported flares lead to suboptimal long-term outcomes. Objectives: To investigate whether transient patient reported flares can influence functional disability in patients with established low active RA. Methods: Out of 287 patients from the AMBRA trial (1), 268 RA patients with low disease activity (DAS28CRP MCID of 0.22) was compared across three groups and the association between flare phenotype and functional outcome was analyzed by logistic regression. Results: 70% were female, median age [IQR] was 63 years [55;70], 73% were rheumatoid factor positive, 71% anti-CCP positive and all had established RA (median [IQR] 7 years [4;13]). Based on the flare questionnaire three groups were distinguished: No-flares group (n=77), transient flares group (n=141) and patients with persistent joint complaints (n=50). Worsening in functional capacity (HAQ>0.22) was seen in 13%, 21% and 40% of patients with no flares, with transient flares and those with persistent joint complaints, respectively (p=0.0015). Compared to the reference group (no flares) worsening in functional capacity was potentially related to "flare phenotype": OR 1.81 (95%CI: 0.83-3.94, p=0.134) for the transient flare status, and statistically significantly associated with persistent joint complaints OR 2.01 (1.22-3.31, p=0.006). Conclusions: RA patients with established low disease activity, who self-report persistent joint complaints have worse functional outcome compared to patients with transient flares and without flares.

KW - patient European human disease activity rheumatoid arthritis rheumatic disease cohort analysis rheumatology functional disease functional status phenotype logistic regression analysis Health Assessment Questionnaire recall disability remission self report

M3 - Conference abstract in journal

VL - 74

SP - 977

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 0003-4967

IS - S2

M1 - AB0255

ER -