Comparing Five Year Out-Come in Two Cohorts of Patients with Early Rheumatoid Arthritis – A BARFOT Study



Maria L.E Andersson*, 1, 2, Kristina Forslind 2, 3, Ingiäld Hafström 4
1 Spenshult Research and Development Centre, Halmstad, Sweden
2 Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden
3 Section of Rheumatology, Department of Internal Medicine, Helsingborgs Lasarett, Helsingborg, Sweden
4 Department of Rheumatology, Karolinska Institutet at Karolinska University Hospital, Huddinge, Sweden


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© Andersson et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Spenshult Research and Development Centre, Bäckagårdsvägen 47, SE-302 74 Halmstad, Sweden; Tel: +46-73-5187043; E-mail: maria.andersson@spenshult.se


Abstract

The objective of the study was to compare disease characteristics over the first 5 years of disease in patients with RA, with disease onset in 1990s and 2000s, respectively.

Methods :

All 2235 patients with early RA (disease duration ≤12 months) were recruited from the BARFOT prospective observational study. These patients were divided into group 1 included 1992 to 1999 (N=1084, 66% women) and group 2 included 2000 to 2006 (N=1151, 69% women). Disease Activity Score (DAS28), VAS pain and Health Assessment Questionnaire (HAQ) were assessed during 5 years. Remission was defined as DAS28 <2.6.

Results :

At inclusion, both women and men in group 2 had higher mean DAS28 (SD) than group 1, 5.42 (1.22) vs 5.26 (1.19), p=0.004 and 5.28 (1.22) vs 5.00 (1.27), p=0.004, respectively, mainly dependant on pain and not on inflammatory related measures. Over time DAS28 decreased and was in both genders, from 6 months to the 5-year follow-up, significantly lower in group 2. At 5-year, both women and men in group 2 had higher rate of remission than women and men in group 1. However, despite reduction of VAS pain and HAQ there were no differences in pain and HAQ between groups at any time point.

Conclusion :

Patients included in the 2000s achieved higher frequency of remission at the 5 year follow-up compared with those included in the 1990s, suggested to reflect the more active medical treatment. Interestingly, however, improvement in pain and HAQ did not differ between the two patient cohorts.

Keywords: Disease activity, early RA, HAQ, pain, “cohort compare”, rheumatoid arthritis. .