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  • 1
    Online Resource
    Online Resource
    A quarter of patients time their early rheumatoid arthritis onset differently than physicians
    BMJ ; 2019
    In:  RMD Open Vol. 5, No. 2 ( 2019-11), p. e000931-
    Details
    In: RMD Open, BMJ, Vol. 5, No. 2 ( 2019-11), p. e000931-
    Abstract: Early rheumatoid arthritis (RA) treatment requires timely recognition. This large, multicentre study compared patient-reported vs physician-reported onset of early RA. Methods Patients from the Canadian Early ArThritis CoHort with early/suspected RA (persistent synovitis 〈 1 year) completed questionnaires asking about the date of symptom onset; and rheumatologists date of onset for persistent synovitis. Groups with similar reported timing (patient and physician) versus differing timing of 30 days or more were compared. Results In 2683 patients, the median patient symptom duration (IQR) was 178 days (163) and physician-reported duration was 166 (138). 1940 (72%) patients had similar patient-reported and physician-reported onset ( 〈 30 days), whereas 497 (18%) reported onset 30 or more days preceding physicians, and 246 (9%) 30 or more days after physicians. Patients reporting onset preceding physicians had lower baseline Disease Activity Score based on 28 joint count, swollen joint counts and erythrocyte sedimentation rate (p 〈 0.05). Patients reporting onset after physicians were more likely to be rheumatoid factor positive (p 〈 0.001) and had higher anticitrullinated protein antibody titres (p 〈 0.009). Regression showed low income, smoking, fibromyalgia, osteoarthritis and baseline non-methotrexate non-biological disease-modifying antirheumatic drug use were predictors for longer patient-reported symptoms. At 12 months, patients reporting longer symptom duration than physicians had lower rates of Simplified Disease Activity Index remission and higher physician global assessments. Conclusion Over one-fourth of patients reported differences of 〉 1 month in symptom onset from their rheumatologist. Patients with longer symptom durations had less improvement at 1 year, which may be reflective of comorbid musculoskeletal conditions.
    Type of Medium: Online Resource
    ISSN: 2056-5933
    URL: Article
    DOI: 10.1136/rmdopen-2019-000931
    Language: English
    Publisher: BMJ
    Publication Date: 2019
    detail.hit.zdb_id: 2812592-7
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  • 2
    Online Resource
    Online Resource
    Predictors of Influenza Vaccination in Early Rheumatoid Arthritis 2017‐2021: Results From the Canadian Early Arthritis Cohort
    Wiley ; 2022
    In:  ACR Open Rheumatology Vol. 4, No. 7 ( 2022-07), p. 566-573
    Details
    In: ACR Open Rheumatology, Wiley, Vol. 4, No. 7 ( 2022-07), p. 566-573
    Abstract: Adults with rheumatoid arthritis (RA) are at a higher risk for infections, including influenza and related complications. We identified influenza vaccination coverage in adults newly diagnosed with RA and examined sociodemographic RA characteristics and attitudes associated with vaccination. Methods We used data from patients enrolled in the Canadian Early Arthritis Cohort between September 2017 and February 2021. At enrollment, participants reported their vaccination status in the previous year and completed the Beliefs About Medicines Questionnaire (BMQ). Clinical data were obtained from medical records. Logistic regression was used to identify predictors of vaccination in the year after RA diagnosis. Results The baseline analytic sample of 431 patients were mostly White (80%) women (67%) with a mean age of 56 (SD 14) years. Prediagnosis, influenza vaccine coverage was 38%, increasing to 46% post diagnosis in the longitudinal sample (n = 229). Participants with previous influenza vaccination (odds ratio [OR] 15.33; 95% confidence interval [CI] 6.37‐36.90), on biologics or JAKs (OR 5.42; 95% CI 1.72‐17.03), and with a higher change in BMQ Necessity‐Concerns Differential scores (OR 1.08; 95% CI 1.02‐1.15) had greater odds, whereas women (OR 0.32; 95% CI 0.14‐0.71), participants with a non‐White racial background (OR 0.13; 95% CI 0.04‐0.51), and participants currently smoking (OR 0.09; 95% CI 0.02‐0.37) had lower odds of influenza vaccine coverage. Conclusion Influenza vaccination coverage in patients with early RA remains below national targets in adults living with a chronic condition. Discussing vaccine history and medication attitudes at initial clinic visits with new patients with RA may enhance vaccine acceptance and uptake.
    Type of Medium: Online Resource
    ISSN: 2578-5745 , 2578-5745
    URL: Issue
    URL: Article
    DOI: 10.1002/acr2.v4.7
    DOI: 10.1002/acr2.11427
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2971160-5
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  • 3
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    Online Resource
    Having More Tender Than Swollen Joints Is Associated With Worse Patient-Reported Outcomes in Patients With Early RA
    Ovid Technologies (Wolters Kluwer Health) ; 2024
    In:  JCR: Journal of Clinical Rheumatology
    Details
    In: JCR: Journal of Clinical Rheumatology, Ovid Technologies (Wolters Kluwer Health)
    Abstract: In patients with rheumatoid arthritis (RA), high tender-swollen joint differences (TSJDs) have been associated with worse outcomes. A better understanding of the phenotype and impact of high TSJD on patient-reported outcomes (PROs) in early RA may lead to earlier personalized treatment targeting domains that are important to patients today. Our objectives were to evaluate the impact of TSJD on updated PROs in patients with early RA over 1 year and to determine differences in associations by joint size. Methods This longitudinal cohort study followed patients with active, early RA enrolled in the Canadian Early Arthritis Cohort between 2016 and 2022, who completed clinical assessments and PROMIS-29 measures over 1 year. Twenty-eight joint counts were performed and TSJDs calculated. Adjusted associations between TSJD and PROMIS-29 scores were estimated using separate linear-mixed models. Separate analyses of large versus small-joint TJSDs were performed. Results Patients with early RA (n = 547; 70% female; mean [SD] age, 56 [15] years; mean [SD] symptom duration, 5.3 [2.9] months) were evaluated. A 1-point increase in TSJD was significantly associated with worse PROMIS T-scores in all domains: physical function (adjusted regression coefficient, −0.27; 95% confidence interval [CI], −0.39, −0.15), social participation (adjusted regression coefficient, −0.34; 95% CI, −0.50, −0.19), pain interference (adjusted regression coefficient, 0.49; 95% CI, 0.35, 0.64), sleep problems (adjusted regression coefficient, 0.29; 95% CI, 0.16, 0.43), fatigue (adjusted regression coefficient, 0.34; 95% CI, 0.18, 0.50), anxiety (adjusted regression coefficient, 0.23; 95% CI, 0.08, 0.38), and depression (adjusted regression coefficient, 0.20; 95% CI, 0.06, 0.35). Large-joint TSJD was associated with markedly worse PROs compared with small-joint TSJD. Conclusions Elevated TSJD is associated with worse PROs particularly pain interference, social participation, and fatigue. Patients with more tender than swollen joints, especially large joints, may benefit from earlier, targeted therapeutic interventions.
    Type of Medium: Online Resource
    ISSN: 1536-7355 , 1076-1608
    URL: Article
    DOI: 10.1097/RHU.0000000000002091
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2024
    detail.hit.zdb_id: 2071025-2
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