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Patient reported outcome data from the Care in Early Rheumatoid Arthritis trial: Opportunities for broadening the scope of treating to target.

Journal article
Authors Kristien Van der Elst
Patrick Verschueren
Veerle Stouten
Sofia Pazmino
An De Groef
Diederik De Cock
Johan Joly
Philip Moons
René Westhovens
Published in Arthritis care & research
ISSN 2151-4658
Publication year 2019
Published at Institute of Health and Care Sciences
Language en
Subject categories Health Sciences, Nursing


Treating early, intensively and to target leads to rapid disease control, preventing joint damage and loss of function in early rheumatoid arthritis (RA). We report the effect of such approach on patient-reported outcomes and explore the contribution of rapid and persistent disease control on wellbeing after 1 year of treatment.This study is part of the Care in early RA trial, a prospective, 2-year, investigator-initiated, randomized controlled trial rooted in daily practice and implementing the treat-to-target principle. SF-36 and IPQ-R data were collected prospectively. We defined 4 clinical response profiles based on speed and consistency of the treatment response within the first year, defined as DAS28CRP<2.6. Linear regression analyses including these response profiles and treatment type were constructed to predict SF-36 dimensions vitality, social functioning, role emotional, mental health, and IPQ-R illness perception subscales consequences, treatment control and illness coherence at year 1.333 patients were available for the main analyses, including 140 early persistent responders. Variation in each of the psychosocial outcomes at year 1 was explained mostly by their baseline values, followed by the clinical response profiles. Patients with an early persistent response reported significantly higher vitality, more positive beliefs about disease consequences and treatment effect. Treatment type did not matter.Rapid and persistent disease control and not treatment type was associated with favorable patient reported health and illness perceptions at year 1, but baseline psychosocial variables mattered most. Our data indicate opportunities to broaden the scope of the treat-to-target principle in early RA. This article is protected by copyright. All rights reserved.

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