Evidence of Diagnostic and Treatment Delay in Seronegative Rheumatoid Arthritis: Missing the Window of Opportunity

Coffey, Caitrín M.; Crowson, Cynthia S.; Myasoedova, Elena; Matteson, Eric L.; Davis, John M.

doi:10.1016/j.mayocp.2019.05.023

Cited by 45 publications

(32 citation statements)

References 16 publications

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“…Seronegative RA is frequently thought of as a milder disease. However, growing evidence suggests delayed diagnosis, more severe disease at presentation and challenges in remission induction in patients with seronegative RA 38 39. In our study, erosions in the first year were more frequent in patients with RA in 2005–2014, and this trend was driven by RF-negative RA that was more prevalent in this recent decade than in the previous decades.…”

Section: Discussionmentioning

confidence: 49%

Is the epidemiology of rheumatoid arthritis changing? Results from a population-based incidence study, 1985–2014

et al. 2020

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ObjectivesTo examine trends in the incidence of rheumatoid arthritis (RA) from 2005 to 2014 overall and by serological status as compared with 1995–2004 and 1985–1994.MethodsWe evaluated RA incidence trends in a population-based inception cohort of individuals aged ≥18 years who first fulfilled the 1987 American College of Rheumatology (ACR) criteria for RA between 1 January 1985 and 31 December 2014. Incidence rates were estimated and were age-adjusted and sex-adjusted to the white population in the USA in 2010. Trends in incidence were examined using Poisson regression methods.ResultsThe 2005–2014 incidence cohort comprised 427 patients: mean age 55.4 years, 68% female, 51% rheumatoid factor (RF) positive and 50% anti-cyclic citrullinated peptide antibody positive. The overall age-adjusted and sex-adjusted annual RA incidence in 2005–2014 was 41/100 000 population (age-adjusted incidence: 53/100 000 in women and 29/100 000 in men). While these estimates were similar to the 1995–2004 decade, there was a decline in the incidence of RF-positive RA in 2005–2014 compared with the previous two decades (p=0.004), with a corresponding increase in RF-negative cases (p<0.001). Smoking rates declined and obesity rates increased from earlier decades to more recent years.ConclusionsSignificant increase in incidence of RF-negative RA and decrease in RF-positive RA in 2005–2014 compared with previous decades was found using 1987 ACR criteria. The incidence of RA overall during this period remained similar to the previous decade. The changing prevalence of environmental factors, such as smoking, obesity and others, may have contributed to these trends. Whether these trends represent a changing serological profile of RA requires further investigation.

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Section: Discussionmentioning

confidence: 49%

Is the epidemiology of rheumatoid arthritis changing? Results from a population-based incidence study, 1985–2014

et al. 2020

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“… 16 Less efficient therapy may well be an explanation for a lower satisfaction in seronegative patients. The association of the patient global assessment with a lower remission rate in seronegative RA in the study of Coffey et al 17 supports these assumptions.…”

Section: Discussionmentioning

confidence: 73%

Factors associated with treatment satisfaction in patients with rheumatoid arthritis: data from the biological register RABBIT

et al. 2020

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ObjectiveTo assess satisfaction with the effectiveness and tolerability of treatments in patients with rheumatoid arthritis (RA).MethodsPatients from the RABBIT register, starting a biological (b) or targeted synthetic (ts) disease-modifying antirheumatic drug (DMARD), or a conventional synthetic (cs)DMARD treatment after ≥1 csDMARD failure, were included. Treatment satisfaction was measured after 1 year of treatment in four categories and binarised for analysis. Logistic regression models were performed to calculate ORs for factors associated with treatment satisfaction.ResultsData of 10 646 patients (74% women, mean 58 years) were analysed. At baseline, 55% of the patients were satisfied with the efficacy and 68% with the tolerability of their previously given treatments. After 1 year, 85% of the patients were satisfied with treatment effectiveness and 90% with tolerability. Baseline satisfaction (OR 2.98, 95% CI 2.58 to 3.44), seropositivity (OR 1.36, 95% CI 1.17 to 1.57), reduction of DAS28 (OR 1.38, 95% CI 1.31 to 1.46) and pain (OR 1.26, 95% CI 1.22 to 1.31), and the improvement of physical capacity (OR 1.22, 95% CI 1.17 to 1.29) were positively associated with treatment satisfaction at follow-up while glucocorticoids (GCs) >5 mg/day, depression, fibromyalgia, obesity, prior bDMARDs and therapy changes were negatively associated. The impact of GC on satisfaction was dose-dependent, becoming strongest for GC >15 mg (OR 0.24, 95% CI 0.16 to 0.34). A 5 mg/day reduction within 12 months was positively associated with satisfaction regarding efficacy (OR 1.19, 95% CI 1.11 to 1.27) and tolerability (OR 1.11, 95% CI 1.03 to 1.21).ConclusionMost patients were satisfied with their treatment’s effectiveness and tolerability after 1 year of treatment. Tapering GCs was positively associated with the improvement of patients’ satisfaction.

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“…Furthermore, RA is challenging to manage and often requires lifelong treatment once developed [ 5 ]. Detection of RA at an early stage affords a window of opportunity for effective curative responses, and this pre-clinical period may be as short as several months [ 6 – 8 ]. Accordingly, early diagnosis of RA is essential to prevent the progression of radiologic variations and select the optimal therapeutic strategy [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

A 9 mRNAs-based diagnostic signature for rheumatoid arthritis by integrating bioinformatic analysis and machine-learning

Liu

Chen

2021

J Orthop Surg Res

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Background Rheumatoid arthritis (RA) is an autoimmune rheumatic disease that carries a substantial burden for both patients and society. Early diagnosis of RA is essential to prevent disease progression and select an optimal therapeutic strategy. However, RA diagnosis is challenging, partly due to a lack of reliable biomarkers. Here, we aimed to explore the diagnostic signature and establish a predictive model of RA. Methods The mRNA expression profiling data of GSE17755, containing blood samples of 112 RA patients and 53 healthy control patients, were obtained from the Gene Expression Omnibus (GEO) database, followed by differential expression, GO (Gene Ontology), and KEGG (Kyoto Encyclopedia of Genes and Genomes) enrichment analysis. A PPI network was constructed to select candidate hub genes, then logistic regression and random forest models were established based on the identified genes. Results Significantly, we identified 52 differentially expressed genes (DEGs), including 16 upregulated genes and 36 downregulated genes in RA samples compared with control samples. GO and KEGG analysis showed that several immune-related cellular processes were particularly enriched. We identified nine hub genes in the PPI network, including CFL1, COTL1, ACTG1, PFN1, LCP1, LCK, HLA-E, FYN, and HLA-DRA. The logistic regression and random forest models based on the nine identified genes reliably distinguished the RA samples from the healthy samples with substantially high AUC. Conclusion The diagnostic logistic regression and random forest models based on nine hub genes reliably predicted the occurrence of RA. Our findings could provide new insights into RA diagnostics.

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Evidence of Diagnostic and Treatment Delay in Seronegative Rheumatoid Arthritis: Missing the Window of Opportunity

Cited by 45 publications

References 16 publications

Is the epidemiology of rheumatoid arthritis changing? Results from a population-based incidence study, 1985–2014

Is the epidemiology of rheumatoid arthritis changing? Results from a population-based incidence study, 1985–2014

Factors associated with treatment satisfaction in patients with rheumatoid arthritis: data from the biological register RABBIT

A 9 mRNAs-based diagnostic signature for rheumatoid arthritis by integrating bioinformatic analysis and machine-learning

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