McWilliams, Daniel F., Zhang, Weiya, Mansell, Josephine S., Kiely, Patrick D.W., Young, Adam and Walsh, David A.
(2012)
Predictors of change in bodily pain in early rheumatoid arthritis: an inception cohort study.
Arthritis Care & Research, 64
(10).
pp. 1505-1513.
ISSN 2151-4658
Full text not available from this repository.
Abstract
Objective: To investigate possible predictors for lack of pain improvement after 1 year of treatment for early rheumatoid arthritis (RA).
Methods: The Early Rheumatoid Arthritis Network (ERAN) database was used for analysis of baseline and 1-year pain data. The ERAN is a hospital-based inception cohort of 1,189 people. Short Form 36 questionnaire bodily pain scores were used to calculate change in pain at 1 year as the outcome. The proportion of the Disease Activity Score in 28 joints (DAS28) attributable to patient-reported components (joint tenderness and visual analog scale score; DAS28-P) at baseline was derived as a predictor. Predictors of less improvement in pain were investigated using adjusted odds ratios (ORadj) generated by logistic regression, adjusting for 14 additional clinical and demographic covariates.
Results: Greater pain at baseline was associated with sex, high DAS28, worse mental health, and smoking. Most patients with early RA reported incomplete improvement in bodily pain after 1 year. The DAS28-P index did not significantly change in the patients whose disease remained active. Less improvement in pain was predicted by female sex (ORadj 3.41, 95% confidence interval [95% CI] 1.35–8.64) and a high DAS28-P index at baseline (ORadj for tertiles 2.09, 95% CI 1.24–3.55). Other conventional RA risk factors did not predict pain changes.
Conclusion: The factors most likely to predict less improvement in pain in early RA are female sex and a high DAS28-P index. A high DAS28-P index may reflect greater contributions of noninflammatory factors, such as central sensitization, to pain. Strategies in addition to inflammatory disease suppression may be required to adequately treat pain.
| Item Type: |
Article
|
| RIS ID: |
https://nottingham-repository.worktribe.com/output/711203 |
| Additional Information: |
McWilliams, D.F., Zhang, W., Mansell, J.S., Kiely, P.D.W., Young, A. and Walsh, D.A. (2012), Predictors of change in bodily pain in early rheumatoid arthritis: An inception cohort study. Arthritis Care Res, 64: 1505–1513. doi:10.1002/acr.21723 |
| Schools/Departments: |
University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Rheumatology, Orthopaedics and Dermatology |
| Identification Number: |
10.1002/acr.21723 |
| Depositing User: |
Chamberlain, Mr Dick
|
| Date Deposited: |
21 May 2014 10:33 |
| Last Modified: |
04 May 2020 16:33 |
| URI: |
https://eprints.nottingham.ac.uk/id/eprint/3172 |
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