Heterogeneous Disease Trajectories Explain Variable Radiographic, Function and Quality of Life Outcomes in the Canadian Early Arthritis Cohort (CATCH)
Identifieur interne : 000699 ( Main/Exploration ); précédent : 000698; suivant : 000700Heterogeneous Disease Trajectories Explain Variable Radiographic, Function and Quality of Life Outcomes in the Canadian Early Arthritis Cohort (CATCH)
Auteurs : Cheryl Barnabe [Canada] ; Ye Sun [Canada] ; Gilles Boire [Canada] ; Carol A. Hitchon [Canada] ; Boulos Haraoui [Canada] ; J. Carter Thorne [Canada] ; Diane Tin [Canada] ; Désirée Van Der Heijde [Pays-Bas] ; Jeffrey R. Curtis [États-Unis] ; Shahin Jamal [Canada] ; Janet E. Pope [Canada] ; Edward C. Keystone [Canada] ; Susan Bartlett [Canada] ; Vivian P. Bykerk [Canada, États-Unis]Source :
- PLoS ONE [ 1932-6203 ] ; 2015.
Abstract
Our objective was to identify distinct trajectories of disease activity state (DAS) and assess variation in radiographic progression, function and quality of life over the first two years of early rheumatoid arthritis (ERA). The CATCH (Canadian early ArThritis CoHort) is a prospective study recruiting ERA patients from academic and community rheumatology clinics in Canada. Sequential DAS28 scores were used to identify five mutually exclusive groups in the cohort (n = 1,586) using growth-based trajectory modeling. Distinguishing baseline sociodemographic and disease variables, treatment required, and differences in radiographic progression and quality of life measures over two years were assessed. The trajectory groups are characterized as: Group 1 (20%) initial high DAS improving rapidly to remission (REM); Group 2 (21%) initial moderate DAS improving rapidly to REM; Group 3 (30%) initial moderate DAS improving gradually to low DAS; Group 4 (19%) initial high DAS improving continuously to low DAS; and Group 5 (10%) initial high DAS improving gradually only to moderate DAS. Groups differed significantly in age, sex, race, education, employment, income and presence of comorbidities. Group 5 had persistent steroid requirements and the highest biologic therapy use. Group 2 had lower odds (OR 0.22, 95%CI 0.09 to 0.58) and Group 4 higher odds (OR 1.94, 95%CI 0.90 to 4.20) of radiographic progression compared to Group 1. Group 1 had the best improvement in physical function (Health Assessment Questionnaire 1.08 (SD 0.68) units), Physical Component Score (16.4 (SD 10.2) units), Mental Component Score (9.7 (SD 12.5) units) and fatigue (4.1 (SD 3.3) units). In conclusion, distinct disease activity state trajectories explain variable outcomes in ERA. Early prediction of disease course to tailor therapy and addressing social determinants of health could optimize outcomes.
Url:
DOI: 10.1371/journal.pone.0135327
PubMed: 26301589
PubMed Central: 4547697
Affiliations:
- Canada, Pays-Bas, États-Unis
- Alabama, Alberta, Hollande-Méridionale, Manitoba, Ontario, Québec, État de New York
- Calgary, Leyde, Montréal, Toronto, Winnipeg
- Université McGill, Université de Calgary, Université de Toronto, Université du Manitoba
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Hitchon</name><affiliation wicri:level="4"><nlm:aff id="aff004"><addr-line>Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Medicine, University of Manitoba, Winnipeg, Manitoba</wicri:regionArea><orgName type="university">Université du Manitoba</orgName><placeName><settlement type="city">Winnipeg</settlement><region type="state">Manitoba</region></placeName></affiliation></author><author><name sortKey="Haraoui, Boulos" sort="Haraoui, Boulos" uniqKey="Haraoui B" first="Boulos" last="Haraoui">Boulos Haraoui</name><affiliation wicri:level="1"><nlm:aff id="aff005"><addr-line>Rheumatic Disease Unit, Institut de Rheumatologie, Montreal, Quebec, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Rheumatic Disease Unit, Institut de Rheumatologie, Montreal, Quebec</wicri:regionArea><wicri:noRegion>Quebec</wicri:noRegion></affiliation></author><author><name sortKey="Thorne, J Carter" sort="Thorne, J Carter" uniqKey="Thorne J" first="J. Carter" last="Thorne">J. Carter Thorne</name><affiliation wicri:level="1"><nlm:aff id="aff006"><addr-line>Southlake Regional Health Centre, Newmarket, Ontario, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Southlake Regional Health Centre, Newmarket, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Tin, Diane" sort="Tin, Diane" uniqKey="Tin D" first="Diane" last="Tin">Diane Tin</name><affiliation wicri:level="1"><nlm:aff id="aff006"><addr-line>Southlake Regional Health Centre, Newmarket, Ontario, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Southlake Regional Health Centre, Newmarket, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Van Der Heijde, Desiree" sort="Van Der Heijde, Desiree" uniqKey="Van Der Heijde D" first="Désirée" last="Van Der Heijde">Désirée Van Der Heijde</name><affiliation wicri:level="3"><nlm:aff id="aff007"><addr-line>Leiden University Medical Centre, Leiden, The Netherlands</addr-line></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Leiden University Medical Centre, Leiden</wicri:regionArea><placeName><settlement type="city">Leyde</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Curtis, Jeffrey R" sort="Curtis, Jeffrey R" uniqKey="Curtis J" first="Jeffrey R." last="Curtis">Jeffrey R. Curtis</name><affiliation wicri:level="2"><nlm:aff id="aff008"><addr-line>University of Alabama at Birmingham, Birmingham, Alabama, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>University of Alabama at Birmingham, Birmingham, Alabama</wicri:regionArea><placeName><region type="state">Alabama</region></placeName></affiliation></author><author><name sortKey="Jamal, Shahin" sort="Jamal, Shahin" uniqKey="Jamal S" first="Shahin" last="Jamal">Shahin Jamal</name><affiliation wicri:level="1"><nlm:aff id="aff009"><addr-line>University of British Columbia, Vancouver, British Columbia, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>University of British Columbia, Vancouver, British Columbia</wicri:regionArea><wicri:noRegion>British Columbia</wicri:noRegion></affiliation></author><author><name sortKey="Pope, Janet E" sort="Pope, Janet E" uniqKey="Pope J" first="Janet E." last="Pope">Janet E. Pope</name><affiliation wicri:level="1"><nlm:aff id="aff010"><addr-line>Western University, London, Ontario, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Western University, London, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Keystone, Edward C" sort="Keystone, Edward C" uniqKey="Keystone E" first="Edward C." last="Keystone">Edward C. Keystone</name><affiliation wicri:level="4"><nlm:aff id="aff002"><addr-line>Division of Rheumatology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Rheumatology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Bartlett, Susan" sort="Bartlett, Susan" uniqKey="Bartlett S" first="Susan" last="Bartlett">Susan Bartlett</name><affiliation wicri:level="4"><nlm:aff id="aff011"><addr-line>McGill University, Montreal, Quebec, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>McGill University, Montreal, Quebec</wicri:regionArea><orgName type="university">Université McGill</orgName><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName></affiliation></author><author><name sortKey="Bykerk, Vivian P" sort="Bykerk, Vivian P" uniqKey="Bykerk V" first="Vivian P." last="Bykerk">Vivian P. Bykerk</name><affiliation wicri:level="4"><nlm:aff id="aff002"><addr-line>Division of Rheumatology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada</addr-line></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Rheumatology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="aff012"><addr-line>Hospital for Special Surgery, Weill Cornell Medical College, New York, New York, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Hospital for Special Surgery, Weill Cornell Medical College, New York, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Our objective was to identify distinct trajectories of disease activity state (DAS) and assess variation in radiographic progression, function and quality of life over the first two years of early rheumatoid arthritis (ERA). The CATCH (Canadian early ArThritis CoHort) is a prospective study recruiting ERA patients from academic and community rheumatology clinics in Canada. Sequential DAS28 scores were used to identify five mutually exclusive groups in the cohort (n = 1,586) using growth-based trajectory modeling. Distinguishing baseline sociodemographic and disease variables, treatment required, and differences in radiographic progression and quality of life measures over two years were assessed. The trajectory groups are characterized as: Group 1 (20%) initial high DAS improving rapidly to remission (REM); Group 2 (21%) initial moderate DAS improving rapidly to REM; Group 3 (30%) initial moderate DAS improving gradually to low DAS; Group 4 (19%) initial high DAS improving continuously to low DAS; and Group 5 (10%) initial high DAS improving gradually only to moderate DAS. Groups differed significantly in age, sex, race, education, employment, income and presence of comorbidities. Group 5 had persistent steroid requirements and the highest biologic therapy use. Group 2 had lower odds (OR 0.22, 95%CI 0.09 to 0.58) and Group 4 higher odds (OR 1.94, 95%CI 0.90 to 4.20) of radiographic progression compared to Group 1. Group 1 had the best improvement in physical function (Health Assessment Questionnaire 1.08 (SD 0.68) units), Physical Component Score (16.4 (SD 10.2) units), Mental Component Score (9.7 (SD 12.5) units) and fatigue (4.1 (SD 3.3) units). In conclusion, distinct disease activity state trajectories explain variable outcomes in ERA. Early prediction of disease course to tailor therapy and addressing social determinants of health could optimize outcomes.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Van Riel, Pl" uniqKey="Van Riel P">PL van Riel</name></author><author><name sortKey="Van Gestel, Am" uniqKey="Van Gestel A">AM van Gestel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Aletaha, D" uniqKey="Aletaha D">D Aletaha</name></author><author><name sortKey="Funovits, J" uniqKey="Funovits J">J Funovits</name></author><author><name sortKey="Keystone, Ec" uniqKey="Keystone E">EC Keystone</name></author><author><name sortKey="Smolen, Js" uniqKey="Smolen J">JS Smolen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Siemons, L" uniqKey="Siemons L">L Siemons</name></author><author><name sortKey="Ten Klooster, Pm" uniqKey="Ten Klooster P">PM Ten Klooster</name></author><author><name 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uniqKey="Odgers C">CL Odgers</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Franklin, Jm" uniqKey="Franklin J">JM Franklin</name></author><author><name sortKey="Shrank, Wh" uniqKey="Shrank W">WH Shrank</name></author><author><name sortKey="Pakes, J" uniqKey="Pakes J">J Pakes</name></author><author><name sortKey="Sanfelix Gimeno, G" uniqKey="Sanfelix Gimeno G">G Sanfelix-Gimeno</name></author><author><name sortKey="Matlin, Os" uniqKey="Matlin O">OS Matlin</name></author><author><name sortKey="Brennan, Ta" uniqKey="Brennan T">TA Brennan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nagin, Ds" uniqKey="Nagin D">DS Nagin</name></author><author><name sortKey="Odgers, Cl" uniqKey="Odgers C">CL Odgers</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Berard, Ra" uniqKey="Berard R">RA Berard</name></author><author><name sortKey="Tomlinson, G" uniqKey="Tomlinson G">G Tomlinson</name></author><author><name sortKey="Li, X" uniqKey="Li X">X Li</name></author><author><name sortKey="Oen, K" uniqKey="Oen K">K Oen</name></author><author><name sortKey="Rosenberg, Am" uniqKey="Rosenberg A">AM Rosenberg</name></author><author><name sortKey="Feldman, Bm" uniqKey="Feldman B">BM Feldman</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Canada</li><li>Pays-Bas</li><li>États-Unis</li></country><region><li>Alabama</li><li>Alberta</li><li>Hollande-Méridionale</li><li>Manitoba</li><li>Ontario</li><li>Québec</li><li>État de New York</li></region><settlement><li>Calgary</li><li>Leyde</li><li>Montréal</li><li>Toronto</li><li>Winnipeg</li></settlement><orgName><li>Université McGill</li><li>Université de Calgary</li><li>Université de Toronto</li><li>Université du Manitoba</li></orgName></list><tree><country name="Canada"><region name="Alberta"><name sortKey="Barnabe, Cheryl" sort="Barnabe, Cheryl" uniqKey="Barnabe C" first="Cheryl" last="Barnabe">Cheryl Barnabe</name></region><name sortKey="Bartlett, Susan" sort="Bartlett, Susan" uniqKey="Bartlett S" first="Susan" last="Bartlett">Susan Bartlett</name><name sortKey="Boire, Gilles" sort="Boire, Gilles" uniqKey="Boire G" first="Gilles" last="Boire">Gilles Boire</name><name sortKey="Bykerk, Vivian P" sort="Bykerk, Vivian P" uniqKey="Bykerk V" first="Vivian P." last="Bykerk">Vivian P. 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Carter Thorne</name><name sortKey="Tin, Diane" sort="Tin, Diane" uniqKey="Tin D" first="Diane" last="Tin">Diane Tin</name></country><country name="Pays-Bas"><region name="Hollande-Méridionale"><name sortKey="Van Der Heijde, Desiree" sort="Van Der Heijde, Desiree" uniqKey="Van Der Heijde D" first="Désirée" last="Van Der Heijde">Désirée Van Der Heijde</name></region></country><country name="États-Unis"><region name="Alabama"><name sortKey="Curtis, Jeffrey R" sort="Curtis, Jeffrey R" uniqKey="Curtis J" first="Jeffrey R." last="Curtis">Jeffrey R. Curtis</name></region><name sortKey="Bykerk, Vivian P" sort="Bykerk, Vivian P" uniqKey="Bykerk V" first="Vivian P." last="Bykerk">Vivian P. Bykerk</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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