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2018 ; 70
(7
): 987-996
Nephropedia Template TP
gab.com Text
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Twit Text #
English Wikipedia
Is Anti-Citrullinated Protein Antibody-Positive Rheumatoid Arthritis Still a More
Severe Disease Than Anti-Citrullinated Protein Antibody-Negative Rheumatoid
Arthritis? A Longitudinal Cohort Study in Rheumatoid Arthritis Patients Diagnosed
From 2000 Onward
#MMPMID29266813
Boer AC
; Boonen A
; van der Helm van Mil AHM
Arthritis Care Res (Hoboken)
2018[Jul]; 70
(7
): 987-996
PMID29266813
show ga
OBJECTIVE: Because of its association with joint destruction, anti-citrullinated
protein antibody (ACPA)-positive rheumatoid arthritis (RA) is considered to be
more severe than ACPA-negative RA. Clinically relevant joint destruction is now
infrequent thanks to adequate disease suppression. According to patients,
important outcomes are pain, fatigue, and independence. We evaluated whether
ACPA-positive RA patients diagnosed during or after 2000 have more severe
self-reported limitations and impairments, including restrictions at work, than
ACPA-negative RA patients. METHODS: A total of 492 ACPA-positive and 450
ACPA-negative RA patients who fulfilled the 2010 criteria and were included in
the Leiden Early Arthritis Clinic cohort during or after 2000 were compared for
self-reported pain, fatigue, disease activity, general well-being (measured by
numerical rating scales), physical function (measured by the Health Assessment
Questionnaire), and work restrictions, including absenteeism at baseline and
during the 4-year followup. Linear mixed models were used. RESULTS: At disease
presentation, ACPA-negative patients had more severe pain, fatigue, self-reported
disease activity scores, and functional disability (P < 0.05), although absolute
differences were small. During followup, ACPA-negative patients remained somewhat
more fatigued (P = 0.002), whereas other patient-reported impairments and
limitations were similar. Thirty-eight percent of ACPA-negative and 48% of
ACPA-positive patients reported absenteeism (P = 0.30), with median 4 days missed
in both groups in the last 3 months. Also, restrictions at work among employed
patients and restrictions with household work were not statistically different at
baseline and during followup. CONCLUSION: In current rheumatology practice,
ACPA-positive RA is not more severe than ACPA-negative RA in terms of patients'
relevant outcomes, including physical functioning and restrictions at work. This
implies that efforts to further improve the disease course should be proportional
to both disease subsets.
|*Severity of Illness Index
[MESH]
|Adult
[MESH]
|Aged
[MESH]
|Anti-Citrullinated Protein Antibodies/*blood
[MESH]