Inflammatory correlates of the Patient Global Assessment of Disease Activity vary in relation to disease duration and autoantibody status in patients with rheumatoid arthritis

医学 自身抗体 类风湿性关节炎 内科学 队列 疾病 类风湿因子 队列研究 前瞻性队列研究 关节炎 免疫学 胃肠病学 抗体
作者
Serena Bugatti,Ludovico De Stefano,Bernardo D’Onofrio,Andrea Nicrosini,Eleonora Mauric,Michele di Lernia,Garifallia Sakellariou,Ennio Giulio Favalli,Antonio Manzo,Roberto Caporali,Carlomaurizio Montecucco
出处
期刊:Annals of the Rheumatic Diseases [BMJ]
卷期号:81 (9): 1206-1213 被引量:8
标识
DOI:10.1136/annrheumdis-2022-222436
摘要

Objective To investigate the associations between the Patient Global Assessment (PGA) and measures of disease activity in patients with rheumatoid arthritis (RA) in relation to disease duration and autoantibody status. Methods 1412 patients from three independent cohorts were studied: a prospective cohort of 810 patients with early RA followed up for 24 months; a cross-sectional cohort of 210 patients with established RA in low disease activity; a cross-sectional cohort of 401 patients with established RA in moderate-to-high disease activity. Correlations of the PGA were analysed by Pearson’s coefficients and multivariable linear regression at baseline and at months 6, 12 and 24 in the overall populations and after stratification for autoantibody subgroup and remission status (Boolean remission, PGA near remission and non-remission). Results In patients with early RA in non-remission, swollen joints correlated independently with the PGA; the correlation became progressively weaker but persisted at all time points in autoantibody-positive patients (adjusted r=0.30–0.12) but lost significance after month 12 in autoantibody-negative patients. Swollen joints independently correlated with the PGA also in near remission until month 12 (adjusted r=0.18–0.16) in autoantibody-positive patients. No independent correlations of inflammatory variables were instead found in patients with established RA irrespective of disease activity and autoantibody status. Conclusions In the early phases of RA, particularly in autoantibody-positive patients, inflammatory variables directly correlate with the PGA across different disease activity states. The optimal cut-off values of the PGA capable of identifying absence of disease should be better explored in relation to disease duration and autoantibody status.
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