Limits...
Heterogeneous Disease Trajectories Explain Variable Radiographic, Function and Quality of Life Outcomes in the Canadian Early Arthritis Cohort (CATCH).

Barnabe C, Sun Y, Boire G, Hitchon CA, Haraoui B, Thorne JC, Tin D, van der Heijde D, Curtis JR, Jamal S, Pope JE, Keystone EC, Bartlett S, Bykerk VP, CATCH Investigato - PLoS ONE (2015)

Bottom Line: Groups differed significantly in age, sex, race, education, employment, income and presence of comorbidities.Group 2 had lower odds (OR 0.22, 95%CI 0.09 to 0.58) and Group 4 higher odds (OR 1.94, 95%CI 0.90 to 4.20) of radiographic progression compared to Group 1.In conclusion, distinct disease activity state trajectories explain variable outcomes in ERA.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine and Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.

ABSTRACT
Our objective was to identify distinct trajectories of disease activity state (DAS) and assess variation in radiographic progression, function and quality of life over the first two years of early rheumatoid arthritis (ERA). The CATCH (Canadian early ArThritis CoHort) is a prospective study recruiting ERA patients from academic and community rheumatology clinics in Canada. Sequential DAS28 scores were used to identify five mutually exclusive groups in the cohort (n = 1,586) using growth-based trajectory modeling. Distinguishing baseline sociodemographic and disease variables, treatment required, and differences in radiographic progression and quality of life measures over two years were assessed. The trajectory groups are characterized as: Group 1 (20%) initial high DAS improving rapidly to remission (REM); Group 2 (21%) initial moderate DAS improving rapidly to REM; Group 3 (30%) initial moderate DAS improving gradually to low DAS; Group 4 (19%) initial high DAS improving continuously to low DAS; and Group 5 (10%) initial high DAS improving gradually only to moderate DAS. Groups differed significantly in age, sex, race, education, employment, income and presence of comorbidities. Group 5 had persistent steroid requirements and the highest biologic therapy use. Group 2 had lower odds (OR 0.22, 95%CI 0.09 to 0.58) and Group 4 higher odds (OR 1.94, 95%CI 0.90 to 4.20) of radiographic progression compared to Group 1. Group 1 had the best improvement in physical function (Health Assessment Questionnaire 1.08 (SD 0.68) units), Physical Component Score (16.4 (SD 10.2) units), Mental Component Score (9.7 (SD 12.5) units) and fatigue (4.1 (SD 3.3) units). In conclusion, distinct disease activity state trajectories explain variable outcomes in ERA. Early prediction of disease course to tailor therapy and addressing social determinants of health could optimize outcomes.

No MeSH data available.


Related in: MedlinePlus

Significant Radiographic Progression During First Year of Follow-up, by Trajectory Group.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4547697&req=5

pone.0135327.g004: Significant Radiographic Progression During First Year of Follow-up, by Trajectory Group.

Mentions: There were no significant differences between groups at baseline in the proportion with erosions or vdHSS (Table 2). However, significant differences in radiographic damage progression are evident by the first year of follow-up (between-group chi-squared p<0.001; Fig 4). Radiographic progression was most frequent in subjects assigned to Groups 4 and 5 at 34% (n = 21/61) and 33% (n = 10/30) respectively, compared to 5% (n = 4/11) in Group 2, 19% (n = 16/85) in Group 3 and 21% (n = 14/68) in Group 1. Using Group 1 as the reference in unadjusted logistic regression models, subjects in Group 2 were found to be protected against radiographic progression (OR 0.22, 95%CI 0.09 to 0.58, p = 0.002), and Group 4 was twice as likely to have significant radiographic progression (OR 2.43, 95%CI 1.27 to 4.65, p = 0.007), and with Group 5 demonstrating numerically higher odds of radiographic progression (OR 1.93, 95%CI 0.90 to 4.20, p = 0.09).


Heterogeneous Disease Trajectories Explain Variable Radiographic, Function and Quality of Life Outcomes in the Canadian Early Arthritis Cohort (CATCH).

Barnabe C, Sun Y, Boire G, Hitchon CA, Haraoui B, Thorne JC, Tin D, van der Heijde D, Curtis JR, Jamal S, Pope JE, Keystone EC, Bartlett S, Bykerk VP, CATCH Investigato - PLoS ONE (2015)

Significant Radiographic Progression During First Year of Follow-up, by Trajectory Group.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4547697&req=5

pone.0135327.g004: Significant Radiographic Progression During First Year of Follow-up, by Trajectory Group.
Mentions: There were no significant differences between groups at baseline in the proportion with erosions or vdHSS (Table 2). However, significant differences in radiographic damage progression are evident by the first year of follow-up (between-group chi-squared p<0.001; Fig 4). Radiographic progression was most frequent in subjects assigned to Groups 4 and 5 at 34% (n = 21/61) and 33% (n = 10/30) respectively, compared to 5% (n = 4/11) in Group 2, 19% (n = 16/85) in Group 3 and 21% (n = 14/68) in Group 1. Using Group 1 as the reference in unadjusted logistic regression models, subjects in Group 2 were found to be protected against radiographic progression (OR 0.22, 95%CI 0.09 to 0.58, p = 0.002), and Group 4 was twice as likely to have significant radiographic progression (OR 2.43, 95%CI 1.27 to 4.65, p = 0.007), and with Group 5 demonstrating numerically higher odds of radiographic progression (OR 1.93, 95%CI 0.90 to 4.20, p = 0.09).

Bottom Line: Groups differed significantly in age, sex, race, education, employment, income and presence of comorbidities.Group 2 had lower odds (OR 0.22, 95%CI 0.09 to 0.58) and Group 4 higher odds (OR 1.94, 95%CI 0.90 to 4.20) of radiographic progression compared to Group 1.In conclusion, distinct disease activity state trajectories explain variable outcomes in ERA.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine and Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.

ABSTRACT
Our objective was to identify distinct trajectories of disease activity state (DAS) and assess variation in radiographic progression, function and quality of life over the first two years of early rheumatoid arthritis (ERA). The CATCH (Canadian early ArThritis CoHort) is a prospective study recruiting ERA patients from academic and community rheumatology clinics in Canada. Sequential DAS28 scores were used to identify five mutually exclusive groups in the cohort (n = 1,586) using growth-based trajectory modeling. Distinguishing baseline sociodemographic and disease variables, treatment required, and differences in radiographic progression and quality of life measures over two years were assessed. The trajectory groups are characterized as: Group 1 (20%) initial high DAS improving rapidly to remission (REM); Group 2 (21%) initial moderate DAS improving rapidly to REM; Group 3 (30%) initial moderate DAS improving gradually to low DAS; Group 4 (19%) initial high DAS improving continuously to low DAS; and Group 5 (10%) initial high DAS improving gradually only to moderate DAS. Groups differed significantly in age, sex, race, education, employment, income and presence of comorbidities. Group 5 had persistent steroid requirements and the highest biologic therapy use. Group 2 had lower odds (OR 0.22, 95%CI 0.09 to 0.58) and Group 4 higher odds (OR 1.94, 95%CI 0.90 to 4.20) of radiographic progression compared to Group 1. Group 1 had the best improvement in physical function (Health Assessment Questionnaire 1.08 (SD 0.68) units), Physical Component Score (16.4 (SD 10.2) units), Mental Component Score (9.7 (SD 12.5) units) and fatigue (4.1 (SD 3.3) units). In conclusion, distinct disease activity state trajectories explain variable outcomes in ERA. Early prediction of disease course to tailor therapy and addressing social determinants of health could optimize outcomes.

No MeSH data available.


Related in: MedlinePlus