Palindromic Rheumatism Frequently Precedes Early Rheumatoid Arthritis: Results From an Incident Cohort

Abstract

BackgroundThis multicenter incident cohort aimed to characterize how often early rheumatoid arthritis (ERA) patients self‐report episodic joint inflammation (palindromic rheumatism) preceding ERA diagnosis and which characteristics differentiate these patients from those without prior episodic symptoms.MethodsData were from patients with early confirmed or suspected RA (more than 6 weeks and less than 12 months) enrolled in the Canadian Early ArThritis CoHort (CATCH) between April 2017 to March 2018 who completed study case report forms assessing joint pain and swelling prior to ERA diagnosis. Chi‐square and t tests were used to compare characteristics of patients with and without self‐reported episodic joint inflammation prior to ERA diagnosis. Multivariable logistic regression was used to identify sociodemographic and clinical measures associated with past episodic joint inflammation around the time of ERA diagnosis.ResultsA total of 154 ERA patients were included; 66% were female, and mean (SD) age and RA symptom duration were 54 (15) years and 141 (118) days. Sixty‐five (42%) ERA patients reported a history of episodic joint pain and swelling, half of whom reported that these symptoms preceded ERA diagnosis by over 6 months. ERA patients with past episodic joint inflammation were more often female, had higher income, were seropositive, had more comorbidities, fewer swollen joints, and lower Clinical Disease Activity Index (CDAI) around the time of ERA diagnosis (P < 0.05). These associations remained significant in multivariable regression adjusting for other sociodemographic and RA clinical measures.ConclusionAlmost half of ERA patients experienced episodic joint inflammation prior to ERA diagnosis. These patients were more often female, had higher income, and presented with milder disease activity at ERA diagnosis.

Palindromic rheumatism: a unique and enigmatic entity with a complex relationship with rheumatoid arthritis

“…RA diagnosis of 42%, However the clinical characteristics and duration of attacks were not documented being difficult to ascertain if all these patients suffered from a typical PR [15].…”

Proteomics and Epidemiological Models of Human Aging

“…However, unlike life-span, which can be precisely defined as the age of death, capturing health-span within the boundaries of a rigid definition and in the context of global health have proved challenging (Newman et al, 2020). The emergence of a disease may be followed by the disappearance of signs and symptoms and a relatively long period of quiescence, such as some rheumatological diseases (Ellingwood et al, 2019). Also, predisposition to one disease may have a strong genetic component, and individuals may be subject to particularly powerful or prolonged environmental exposure (Rohn, 2014;Belloy et al, 2019).…”