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Level of radiographic damage and radiographic progression are determinants of physical function: a longitudinal analysis of the TEMPO trial.

van der Heijde D, Landewé R, van Vollenhoven R, Fatenejad S, Klareskog L - Ann. Rheum. Dis. (2008)

Bottom Line: However, it is not known if short-term radiographic progression is also associated with physical function.After adjustment for age, sex and disease activity, both TSS and the change in TSS (progression rate) were significant determinants of the HAQ score.When radiographic progression was divided into four categories (negative, zero, minor and greater progression), results showed that HAQ scores tended to be higher with a higher rate of progression.

View Article: PubMed Central - PubMed

Affiliation: Department of Rheumatology, Leiden University Medical Centre, PO Box 9600, 2300 CC Leiden, The Netherlands. d.vanderheijde@kpnplanet.nl

ABSTRACT

Background: Many studies have examined the relationship between long-term radiographic damage and physical function. However, it is not known if short-term radiographic progression is also associated with physical function.

Aim: To investigate the longitudinal relationship between physical function and both the level of radiographic damage and the radiographic progression rate in patients with early or advanced active rheumatoid arthritis.

Methods: The database for the 2-year Trial of Etanercept and Methotrexate with Radiographic Patient Outcomes (TEMPO) was used for this study. Physical function was measured by the Health Assessment Questionnaire (HAQ) score at baseline, 6 months and 1 and 2 years. Radiographs of the hands and feet, taken at the same time points, were scored by the van der Heijde-modified Total Sharp Score (TSS). The HAQ score was modelled using generalised mixed linear modelling by TSS or progression in TSS (interval 0-1 year and 1-2 years) adjusted for age, sex, treatment and disease activity.

Results: After adjustment for age, sex and disease activity, both TSS and the change in TSS (progression rate) were significant determinants of the HAQ score. When radiographic progression was divided into four categories (negative, zero, minor and greater progression), results showed that HAQ scores tended to be higher with a higher rate of progression. Patients with negative progression scores had lower HAQ scores than patients with positive progression scores.

Conclusions: Patients with greater radiographic damage, and those with recent radiographic progression, have a higher degree of disability.

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Related in: MedlinePlus

Marginal means for the Health Assessment Questionnaire (HAQ) score, adjusted for age, sex, disease duration, treatment, disease activity score (DAS), Sharp score and time, as a function of change in Sharp score (four categories of progression; error bars reflect standard error).
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ARD-67-09-1267-f03: Marginal means for the Health Assessment Questionnaire (HAQ) score, adjusted for age, sex, disease duration, treatment, disease activity score (DAS), Sharp score and time, as a function of change in Sharp score (four categories of progression; error bars reflect standard error).

Mentions: Figure 3 shows the effect of changes in radiographic damage on physical function, with progression of radiographic damage stratified into four categories (negative, zero, minor and greater progression). HAQ scores tended to increase with increasing radiographic progression, although the differences were small and probably not clinically meaningful. Figure 3 also suggests that patients with negative progression scores have lower HAQ scores than patients with positive progression scores, but this effect was not statistically significant.


Level of radiographic damage and radiographic progression are determinants of physical function: a longitudinal analysis of the TEMPO trial.

van der Heijde D, Landewé R, van Vollenhoven R, Fatenejad S, Klareskog L - Ann. Rheum. Dis. (2008)

Marginal means for the Health Assessment Questionnaire (HAQ) score, adjusted for age, sex, disease duration, treatment, disease activity score (DAS), Sharp score and time, as a function of change in Sharp score (four categories of progression; error bars reflect standard error).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2571961&req=5

ARD-67-09-1267-f03: Marginal means for the Health Assessment Questionnaire (HAQ) score, adjusted for age, sex, disease duration, treatment, disease activity score (DAS), Sharp score and time, as a function of change in Sharp score (four categories of progression; error bars reflect standard error).
Mentions: Figure 3 shows the effect of changes in radiographic damage on physical function, with progression of radiographic damage stratified into four categories (negative, zero, minor and greater progression). HAQ scores tended to increase with increasing radiographic progression, although the differences were small and probably not clinically meaningful. Figure 3 also suggests that patients with negative progression scores have lower HAQ scores than patients with positive progression scores, but this effect was not statistically significant.

Bottom Line: However, it is not known if short-term radiographic progression is also associated with physical function.After adjustment for age, sex and disease activity, both TSS and the change in TSS (progression rate) were significant determinants of the HAQ score.When radiographic progression was divided into four categories (negative, zero, minor and greater progression), results showed that HAQ scores tended to be higher with a higher rate of progression.

View Article: PubMed Central - PubMed

Affiliation: Department of Rheumatology, Leiden University Medical Centre, PO Box 9600, 2300 CC Leiden, The Netherlands. d.vanderheijde@kpnplanet.nl

ABSTRACT

Background: Many studies have examined the relationship between long-term radiographic damage and physical function. However, it is not known if short-term radiographic progression is also associated with physical function.

Aim: To investigate the longitudinal relationship between physical function and both the level of radiographic damage and the radiographic progression rate in patients with early or advanced active rheumatoid arthritis.

Methods: The database for the 2-year Trial of Etanercept and Methotrexate with Radiographic Patient Outcomes (TEMPO) was used for this study. Physical function was measured by the Health Assessment Questionnaire (HAQ) score at baseline, 6 months and 1 and 2 years. Radiographs of the hands and feet, taken at the same time points, were scored by the van der Heijde-modified Total Sharp Score (TSS). The HAQ score was modelled using generalised mixed linear modelling by TSS or progression in TSS (interval 0-1 year and 1-2 years) adjusted for age, sex, treatment and disease activity.

Results: After adjustment for age, sex and disease activity, both TSS and the change in TSS (progression rate) were significant determinants of the HAQ score. When radiographic progression was divided into four categories (negative, zero, minor and greater progression), results showed that HAQ scores tended to be higher with a higher rate of progression. Patients with negative progression scores had lower HAQ scores than patients with positive progression scores.

Conclusions: Patients with greater radiographic damage, and those with recent radiographic progression, have a higher degree of disability.

Show MeSH
Related in: MedlinePlus