Brief Report: Predicting Functional Disability: One-Year Results From the Scottish Early Rheumatoid Arthritis Inception Cohort.
Caroline Kronisch,David J. McLernon,James Dale,Caron Paterson,Stuart H. Ralston,David M. Reid,Ann Tierney,John Harvie,Neil McKay,Hilary Wilson,Robin Munro,Sarah Saunders,Ruth Richmond,Derek Baxter,Mike McMahon,Vinod Kumar,John McLaren,Stefan Siebert,Iain B. McInnes,Duncan Porter,Gary J. Macfarlane,Neil Basu +21 more
TLDR
The Scottish Early Rheumatoid Arthritis (SERA) inception cohort is a multicenter, prospective study of patients with newly presenting RA or undifferentiated arthritis.Abstract:
Objective
To identify baseline prognostic indicators of disability at 1 year within a contemporary early inflammatory arthritis inception cohort and then develop a clinically useful tool to support early patient education and decision-making.
Methods
The Scottish Early Rheumatoid Arthritis (SERA) inception cohort is a multicenter, prospective study of patients with newly presenting RA or undifferentiated arthritis. SERA data were analyzed to determine baseline predictors of disability (defined as a Health Assessment Questionnaire [HAQ] score of ≥1) at 1 year. Clinical and psychosocial baseline exposures were entered into a forward stepwise logistic regression model. The model was externally validated using newly accrued SERA data and subsequently converted into a prediction tool.
Results
Of the 578 participants (64.5% female), 36.7% (n = 212) reported functional disability at 1 year. Functional disability was independently predicted by baseline disability (odds ratio [OR] 2.67 [95% confidence interval (95% CI) 1.98, 3.59]), depression (OR 2.52 [95% CI 1.18, 5.37]), anxiety (OR 2.37 [95% CI 1.33, 4.21]), being in paid employment with absenteeism during the last week (OR 1.19 [95% CI 0.63, 2.23]), not being in paid employment (OR 2.36 [95% CI 1.38, 4.03]), and being overweight (OR 1.61 [95% CI 1.04, 2.50]). External validation (using 113 newly acquired patients) evidenced good discriminative performance with a C statistic of 0.74, and the calibration slope showed no evidence of model overfit (P = 0.31).
Conclusion
In the context of modern early inflammatory arthritis treatment paradigms, predictors of disability at 1 year appear to be dominated by psychosocial rather than more traditional clinical measures. This indicates the potential benefit of early access to nonpharmacologic interventions targeting key psychosocial factors, such as mental health and work disability.read more
Citations
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The association of fatigue, pain, depression and anxiety with work and activity impairment in immune mediated inflammatory diseases.
Murray W. Enns,Charles N. Bernstein,Kristine Kroeker,Lesley A. Graff,John R. Walker,Lisa M. Lix,Carol A. Hitchon,Renée El-Gabalawy,John D. Fisk,Ruth Ann Marrie +9 more
TL;DR: The association between pain, depression symptoms, anxiety symptoms, and fatigue individually showed significant associations with work absenteeism, presenteeism, and general activity impairment in four patient populations using quantile regression.
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Genome-wide association study of response to methotrexate in early rheumatoid arthritis patients.
John C. Taylor,Tim Bongartz,Jonathan Massey,Borbala Mifsud,Athina Spiliopoulou,Ian C. Scott,Ian C. Scott,Jianmei Wang,Michael D Morgan,Michael D Morgan,Darren Plant,Marco Colombo,Peter Orchard,Sarah Twigg,Iain B. McInnes,Duncan Porter,Jane E. Freeston,Jackie L Nam,Heather J. Cordell,John D. Isaacs,Jenna L. Strathdee,Donna K. Arnett,Maria J. H. de Hair,Paul P. Tak,Stella Aslibekyan,Ronald F van Vollenhoven,Leonid Padyukov,S. Louis Bridges,Costantino Pitzalis,Andrew P. Cope,Suzanne M M Verstappen,Paul Emery,Michael R. Barnes,Felix Agakov,Paul M. McKeigue,Taisei Mushiroda,Michiaki Kubo,Richard M. Weinshilboum,Anne Barton,Ann W. Morgan,Jennifer H. Barrett +40 more
TL;DR: A genome-wide study of response to MTX in 1424 early RA patients of European ancestry found the strongest evidence for association was with rs168201 in NRG3, but some support was also seen for association with ZMIZ1.
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Functional disability associated with disease and quality-of-life parameters in Chinese patients with rheumatoid arthritis
TL;DR: A low quality of life and limitation of joint mobility had great impacts on functional disability in Chinese RA patients, and targeted and culturally sensitive interventions should be strengthened to delay the onset of disabilities.
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Chromosome conformation signatures define predictive markers of inadequate response to methotrexate in early rheumatoid arthritis.
Claudio Carini,Ewan Hunter,Aroul Ramadass,Jayne Green,Alexandre Akoulitchev,Iain B. McInnes,Carl S. Goodyear +6 more
TL;DR: It is demonstrated that detection of a CCS in blood in early RA is able to predict inadequate response to MTX with a high degree of accuracy, offering a mechanism to provide alternative treatments for non-responders toMTX earlier in the course of the disease.
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GeneImp: Fast Imputation to Large Reference Panels Using Genotype Likelihoods from Ultralow Coverage Sequencing.
TL;DR: GeneImp is the first practical choice for whole-genome imputation to a dense reference panel when prephasing cannot be applied, for instance, in datasets produced via ultralow coverage sequencing.
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