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Comparison between women and men with recent onset rheumatoid arthritis of disease activity and functional ability over two years (the TIRA project)
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  1. E Hallert1,
  2. I Thyberg2,3,
  3. U Hass4,
  4. E Skargren5,
  5. T Skogh2
  1. 1Department of Internal Medicine, Vrinnevi Hospital, Norrköping, Sweden
  2. 2Division of Rheumatology, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University, Sweden
  3. 3Swedish Institute for Disability Research, Linköping and Örebro University, Sweden
  4. 4Centre for Medical Technology Assessment, Department of Health and Society, Linköping University, Sweden
  5. 5Division of Physiotherapy, Department of Health and Society, Linköping University, Sweden
  1. Correspondence to:
    Professor T Skogh, Division of Rheumatology, Linköping University Hospital, SE-581 85 Linköping, Sweden;
    thomas.skogh{at}lio.se

Abstract

Objective: To describe the course of recent onset rheumatoid arthritis (RA) and to compare consequences of the disease in men and women.

Methods: 284 patients with recent onset RA were followed up prospectively for two years from the time of diagnosis. Measures of disease activity (for example, 28 joint disease activity score (DAS28), C reactive protein, morning stiffness, physician’s global assessment) and function outcome (for example, range of movement, hand function, walking time) were determined. The patients’ self reported assessment of functional capacity (Health Assessment Questionnaire (HAQ)) and grading of wellbeing and pain (visual analogue scale) were registered. Changes over time and differences between men and women were evaluated.

Results: Improvements were seen for all variables within the first three months. Disease activity then remained unchanged. Function variables followed the same pattern during the first year, but then tended to worsen. HAQ scores were similar at baseline, but significantly worse in women than in men at the one and two year follow ups.

Conclusions: Disease activity was well managed and had improved substantially after two years, whereas function seemed slowly to deteriorate. Although disease variables were similar for men and women, functional ability (HAQ) had a less favourable course in women.

  • early rheumatoid arthritis
  • outcome
  • disability
  • sex
  • CRP, C reactive protein
  • DAS28, 28 joint disease activity score
  • DMARDs, disease modifying antirheumatic drugs
  • ESR, erythrocyte sedimentation rate
  • HAQ, Health Assessment Questionnaire
  • NSAIDs, non-steroidal anti-inflammatory drugs
  • PGA, physician’s global assessment of disease activity
  • RA, rheumatoid arthritis
  • SOFI, signs of functional impairment
  • VAS, visual analogue scale
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