Heterogeneous Disease Trajectories Explain Variable Radiographic, Function and Quality of Life Outcomes in the Canadian Early Arthritis Cohort (CATCH)
Identifieur interne : 001C86 ( Ncbi/Merge ); précédent : 001C85; suivant : 001C87Heterogeneous 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
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<author><name sortKey="Thorne, J Carter" sort="Thorne, J Carter" uniqKey="Thorne J" first="J. Carter" last="Thorne">J. Carter Thorne</name>
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<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>
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<author><name sortKey="Keystone, Edward C" sort="Keystone, Edward C" uniqKey="Keystone E" first="Edward C." last="Keystone">Edward C. Keystone</name>
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<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>
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<author><name sortKey="Keystone, Ec" uniqKey="Keystone E">EC Keystone</name>
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<author><name sortKey="Glas, Ca" uniqKey="Glas C">CA Glas</name>
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<author><name sortKey="Van De Laar, M" uniqKey="Van De Laar M">M Van de Laar</name>
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<author><name sortKey="Jamal, S" uniqKey="Jamal S">S Jamal</name>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id>
<journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id>
<journal-id journal-id-type="publisher-id">plos</journal-id>
<journal-id journal-id-type="pmc">plosone</journal-id>
<journal-title-group><journal-title>PLoS ONE</journal-title>
</journal-title-group>
<issn pub-type="epub">1932-6203</issn>
<publisher><publisher-name>Public Library of Science</publisher-name>
<publisher-loc>San Francisco, CA USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">26301589</article-id>
<article-id pub-id-type="pmc">4547697</article-id>
<article-id pub-id-type="doi">10.1371/journal.pone.0135327</article-id>
<article-id pub-id-type="publisher-id">PONE-D-15-27734</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Heterogeneous Disease Trajectories Explain Variable Radiographic, Function and Quality of Life Outcomes in the Canadian Early Arthritis Cohort (CATCH)</article-title>
<alt-title alt-title-type="running-head">Outcome Trajectories in Early Rheumatoid Arthritis</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Barnabe</surname>
<given-names>Cheryl</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sun</surname>
<given-names>Ye</given-names>
</name>
<xref ref-type="aff" rid="aff002"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Boire</surname>
<given-names>Gilles</given-names>
</name>
<xref ref-type="aff" rid="aff003"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hitchon</surname>
<given-names>Carol A.</given-names>
</name>
<xref ref-type="aff" rid="aff004"><sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Haraoui</surname>
<given-names>Boulos</given-names>
</name>
<xref ref-type="aff" rid="aff005"><sup>5</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Thorne</surname>
<given-names>J. Carter</given-names>
</name>
<xref ref-type="aff" rid="aff006"><sup>6</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Tin</surname>
<given-names>Diane</given-names>
</name>
<xref ref-type="aff" rid="aff006"><sup>6</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>van der Heijde</surname>
<given-names>Désirée</given-names>
</name>
<xref ref-type="aff" rid="aff007"><sup>7</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Curtis</surname>
<given-names>Jeffrey R.</given-names>
</name>
<xref ref-type="aff" rid="aff008"><sup>8</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Jamal</surname>
<given-names>Shahin</given-names>
</name>
<xref ref-type="aff" rid="aff009"><sup>9</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Pope</surname>
<given-names>Janet E.</given-names>
</name>
<xref ref-type="aff" rid="aff010"><sup>10</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Keystone</surname>
<given-names>Edward C.</given-names>
</name>
<xref ref-type="aff" rid="aff002"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bartlett</surname>
<given-names>Susan</given-names>
</name>
<xref ref-type="aff" rid="aff011"><sup>11</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bykerk</surname>
<given-names>Vivian P.</given-names>
</name>
<xref ref-type="aff" rid="aff002"><sup>2</sup>
</xref>
<xref ref-type="aff" rid="aff012"><sup>12</sup>
</xref>
<xref rid="cor001" ref-type="corresp">*</xref>
</contrib>
<contrib contrib-type="author"><collab>CATCH Investigators</collab>
<xref ref-type="author-notes" rid="fn001"><sup>¶</sup>
</xref>
</contrib>
</contrib-group>
<aff id="aff001"><label>1</label>
<addr-line>Department of Medicine and Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada</addr-line>
</aff>
<aff id="aff002"><label>2</label>
<addr-line>Division of Rheumatology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada</addr-line>
</aff>
<aff id="aff003"><label>3</label>
<addr-line>Department of Medicine, Universite de Sherbrooke, Sherbrooke, Quebec, Canada</addr-line>
</aff>
<aff id="aff004"><label>4</label>
<addr-line>Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada</addr-line>
</aff>
<aff id="aff005"><label>5</label>
<addr-line>Rheumatic Disease Unit, Institut de Rheumatologie, Montreal, Quebec, Canada</addr-line>
</aff>
<aff id="aff006"><label>6</label>
<addr-line>Southlake Regional Health Centre, Newmarket, Ontario, Canada</addr-line>
</aff>
<aff id="aff007"><label>7</label>
<addr-line>Leiden University Medical Centre, Leiden, The Netherlands</addr-line>
</aff>
<aff id="aff008"><label>8</label>
<addr-line>University of Alabama at Birmingham, Birmingham, Alabama, United States of America</addr-line>
</aff>
<aff id="aff009"><label>9</label>
<addr-line>University of British Columbia, Vancouver, British Columbia, Canada</addr-line>
</aff>
<aff id="aff010"><label>10</label>
<addr-line>Western University, London, Ontario, Canada</addr-line>
</aff>
<aff id="aff011"><label>11</label>
<addr-line>McGill University, Montreal, Quebec, Canada</addr-line>
</aff>
<aff id="aff012"><label>12</label>
<addr-line>Hospital for Special Surgery, Weill Cornell Medical College, New York, New York, United States of America</addr-line>
</aff>
<contrib-group><contrib contrib-type="editor"><name><surname>Kuwana</surname>
<given-names>Masataka</given-names>
</name>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
</contrib-group>
<aff id="edit1"><addr-line>Nippon Medical School Graduate School of Medicine, JAPAN</addr-line>
</aff>
<author-notes><fn fn-type="conflict" id="coi001"><p><bold>Competing Interests: </bold>
The CATCH study was designed and implemented by the investigators and financially supported initially by Amgen Canada Inc. and Pfizer Canada Inc. via an unrestricted research grant since inception of CATCH. As of 2011, further support was provided by Hoffmann-La Roche Ltd., United Chemicals of Belgium (UCB) Canada Inc., Bristol-Myers Squibb Canada Co., Abbott Laboratories Ltd., and Janssen Biotech Inc. (a wholly owned subsidiary of Johnson & Johnson Inc.). Cheryl Barnabe received advisory board honoraria from the following commercial sources: Amgen Canada Inc. and Pfizer Canada Inc. Hoffmann-La Roche Ltd., United Chemicals of Belgium (UCB) Canada Inc., Bristol-Myers Squibb Canada Co., Abbott Laboratories Ltd., and Janssen Biotech Inc. (a wholly owned subsidiary of Johnson & Johnson Inc.). There are no patents, products in development or marketed products to declare. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.</p>
</fn>
<fn fn-type="con" id="contrib001"><p>Conceived and designed the experiments: VPB YS CB GB CAH BH JCT DvdH SJ JEP ECK SB. Analyzed the data: YS CB VPB. Contributed reagents/materials/analysis tools: CB GB CAH BH JCT DvdH SJ JEP ECK VPB. Wrote the paper: CB YS GB CAH BH JCT DT DvdH JRC SJ JEP ECK SB VPB.</p>
</fn>
<fn fn-type="other" id="fn001"><p>¶ Membership of the CATCH Cohort is provided in the Acknowledgments.</p>
</fn>
<corresp id="cor001">* E-mail: <email>bykerkv@hss.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="epub"><day>24</day>
<month>8</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="collection"><year>2015</year>
</pub-date>
<volume>10</volume>
<issue>8</issue>
<elocation-id>e0135327</elocation-id>
<history><date date-type="received"><day>24</day>
<month>6</month>
<year>2015</year>
</date>
<date date-type="accepted"><day>21</day>
<month>7</month>
<year>2015</year>
</date>
</history>
<permissions><copyright-year>2015</copyright-year>
<copyright-holder>Barnabe et al</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>
, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited</license-p>
</license>
</permissions>
<self-uri content-type="pdf" xlink:type="simple" xlink:href="pone.0135327.pdf"></self-uri>
<abstract><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>
</abstract>
<funding-group><funding-statement>The CATCH study was designed and implemented by the investigators and financially supported initially by Amgen Canada Inc. and Pfizer Canada Inc. via an unrestricted research grant since inception of CATCH. As of 2011, further support was provided by Hoffmann-La Roche Ltd., United Chemicals of Belgium (UCB) Canada Inc., Bristol-Myers Squibb Canada Co., Abbott Laboratories Ltd., and Janssen Biotech Inc. (a wholly owned subsidiary of Johnson & Johnson Inc.). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funding-statement>
</funding-group>
<counts><fig-count count="4"></fig-count>
<table-count count="3"></table-count>
<page-count count="13"></page-count>
</counts>
<custom-meta-group><custom-meta id="data-availability"><meta-name>Data Availability</meta-name>
<meta-value>All relevant data are within the paper and its Supporting Information files.</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
<notes><title>Data Availability</title>
<p>All relevant data are within the paper and its Supporting Information files.</p>
</notes>
</front>
</pmc>
<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>
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<tree><country name="Canada"><region name="Alberta"><name sortKey="Barnabe, Cheryl" sort="Barnabe, Cheryl" uniqKey="Barnabe C" first="Cheryl" last="Barnabe">Cheryl Barnabe</name>
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<name sortKey="Hitchon, Carol A" sort="Hitchon, Carol A" uniqKey="Hitchon C" first="Carol A." last="Hitchon">Carol A. Hitchon</name>
<name sortKey="Jamal, Shahin" sort="Jamal, Shahin" uniqKey="Jamal S" first="Shahin" last="Jamal">Shahin Jamal</name>
<name sortKey="Keystone, Edward C" sort="Keystone, Edward C" uniqKey="Keystone E" first="Edward C." last="Keystone">Edward C. Keystone</name>
<name sortKey="Pope, Janet E" sort="Pope, Janet E" uniqKey="Pope J" first="Janet E." last="Pope">Janet E. Pope</name>
<name sortKey="Sun, Ye" sort="Sun, Ye" uniqKey="Sun Y" first="Ye" last="Sun">Ye Sun</name>
<name sortKey="Thorne, J Carter" sort="Thorne, J Carter" uniqKey="Thorne J" first="J. Carter" last="Thorne">J. Carter Thorne</name>
<name sortKey="Tin, Diane" sort="Tin, Diane" uniqKey="Tin D" first="Diane" last="Tin">Diane Tin</name>
</country>
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<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>
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