Table 3

Extended overview of selected articles

First author, year publicationrefStudy designPopulation, LocationNAge, years mean±SD or median (IQR)Female (%)Symptom duration (months) mean ±SD or median (IQR)Definition symptom onsetOutcome of relevanceAdjustment factorsRelevant results
Bosello, 201112OC1987+ RA, Italy12153.6±13.3765.7±3.5NR ▸ Radiographic joint damage (defined ≥1 unit increase in of SHS/Larsen erosions score) after 1 year FU  ▸ ACR remission ▸ Sex, erosive disease, HAQ  ▸ Sex, RF, ACPA, ESR, SJC ▸ Not having ‘VERA’ predictor of erosiveness at 12 months, OR 2.4 (95% CI 1.1 to 5.6)  ▸ ‘VERA’ predictor for ACR remission ,OR 5.3 (95% CI 2.1 to 13.0)
Dixey, 200413OC1987+RA, UK (ERAS)866<45 : 24% 45–60: 40% >60 : 36%666 (4–11)NRRadiographic outcome at 3 years (by Larsen score; cut-off median erosions score and the worst quartilenoneSymptom duration (weeks) on radiographic outcome, OR 1.86 (95% CI 1.30 to 2.66)
De Rooy, 20109OC1987+ RA, Netherlands (EAC Leiden)67656.4±15.767.96.1±5.2Onset of joint symptoms reported by the patientArthritis persistency (the reverse of DMARD-free sustained remission)Age, sex, inclusion period (as proxy for treatment strategy)Symptom duration (weeks) OR 1.011 on arthritis persistency (95% CI 1.002 to 1.019), p=0.012
Gremese, 201214OC (3 cohorts combined)1987+ and 2010+ RA patients, Italy48154.4±±3.3NRDAS-28 (<2.6) remission at 12 months FUDAS-28, HAQ, ACPA, erosions, DMARDs within 3 months‘VERA’ on DAS-28 remission, OR 2.03 (95% CI 1.15 to 3.30)
Hodkinson, 201215OC1987+ RA, South-Africa17147.1±12.481.911.7±7.1NRLow disease activity (LDA) at 12 months (SDAI≤11) versus moderate/high disease activity (MDA/HDA; SDAI≥11)NoneLDA symptom duration 9.9±6.9 months vs MDA/HDA 11.7±6.8 months. (mean±SD)
Not significant (p value unknown).
Jansen, 200116OC1987+ RA, Netherlands13065(21–86)673 (0–24)Onset of persistent pain and swelling reported by the patientΔ radiographic damage at 1 year (by SHS).NoneSymptom duration was correlated with radiographic progression (p<0.005)
Jayakumar, 201217OC1987+ RA, UK (ERAS)70455 (45–64)65.67 (4–12)NRSustained remission DAS-28<1.6 after 5 years FUSex, TJC, treatment and many other baseline variablesSymptom duration <6 months OR 3.15 (95% CI 1.03 to 10.0, p=0.046)
Kaufmann, 200318 OC1987+ RA, Germany5456 (30–38)83.3<6 months: 27 (50%)NRRadiographic progression defined by yearly increase of Larsen score ≥5.8Age, sex, RF, HLA-DR4 SE, erosions, ESR and CRPSymptom duration (>6 months) on severe radiographic progression OR=1.05, p value=0.826
Lukas, 201122OCRA according to the rheumatologist, France (ESPOIR)66148.6±12.177.2<3 months 32% >3 months 68%Onset of swollen joints reported by the patientRadiographic progression after 1 year of follow-up (by Δ SHS units)DAS-28, RF, involvement>3joint groups, CRP, ACPA, treatment (propensity score)Symptom duration <3 months vs >3 months: estimated marginal means 0.8 units (SEM 0.37) versus 1.7 units (SEM 0.19), p=0.033
Mötönnen, 200223RCT1987+ RA, Finland (FIN-RACo)165Mean age varied 46–50  years between the arms62Combination arm: 6 (4–9) Single arm: 7 (4–11)NRACR remission at 2 years FU (fatigue and duration criteria excluded)age, sex, SE, RF and number of other ACR1987 criteria fulfilledEstimated proportion of remission in:   – The single treatment group for symptom duration 0–4 months ∼36% vs >4 months ∼10%, p=0.010   – The combination treatment group symptom duration 0–4 months ∼43% vs >4 months ∼40%, p=0.83
Nell, 200424OC1987+ RA, Austria4054 (25–80)75VERA 3 (2–4) LERA 12 (9–30)NR ▸ Radiographic progression (Δ Larsen score)  ▸ DAS-28 improvement/remission (<2.6)  ▸ HAQ improvement All outcomes after 3 years FUNone ▸ VERA patients had an increase of 3.6±6.5 units compared with an increase of 14.7±9.9 Larsen units in LERA, p<0.05. (mean±SD)  ▸ DAS <2.6 was obtained in 50% of VERA and 15% of the LERA patients (p<0.05).  ▸ Change in HAQ score: VERA −0.7±0.7 (−78%), LERA −0.4±0.6 (−44%), p<0.05.
Pascual-Ramos, 200925OC1987+ RA, Mexico72NRNRErosive 4.9±2.9 And non-erosive dise 6.5±1.8NRJoint damage (erosive disease yes/no) at 1 year FUNoneSymptom duration (months) on erosive disease OR 1.16 (95% CI 0.97 to 1.4), p=0.11
Sanmarti, 200327OC1987+ RA, Spain6052.2±15.778.39.5±6.5NRRadiographic progression at 1 year (Larsen Score; progression defined as >2 units)All baseline variables with p<0.15 in univariable analysisMultivariable; symptom duration n (months) OR 1.15 (95% CI 1.03 to 1.28), p<0.05
Soderlin, 201128OC1987+ RA, Sweden (BARFOT)18058±15685.8±12NR ▸ 1 year good EULAR response  ▸ Mean Δ HAQ change at 1 yearAge, sex, smoking, RF, HAQ, treatment, DAS-28 ▸ Patients with a good/moderate EULAR response in case of symptom duration <12 weeks 81%, 13–24 weeks 82% and 25–52 weeks 76%, p=0.03.  ▸ HAQ and symptom duration: correlation coefficient=0.12, p=0.0001
Van der Linden, 201021OC1987+ RA, Netherlands (EAC Leiden)59856.8±15.867.74.2 (2.4–8.1)Onset of joint symptom reported by the patientSHS progression over 6 years based on yearly made x-raysAge, sex, inclusion period (as proxy for treatment strategy)Patients with symptom duration >12 weeks have a 1.34-fold higher progression ratio than patients with symptom duration <12 weeks, over a period of 6 years (p=0.001)
van der Woude, 20099OC1987+ RA, UK (ERAS)89552±13698.3±6NRDMARD-free sustained remissionAll baseline variables with p<010 univariable analysis ▸ Multivariable; Symptom duration on achieving DMARD-free remission, HR 0.94 (95% CI 0.89 to 0.99), p=0.029
Van der Woude, 201211RCT1987+ RA, Netherlands (BeSt Trial)50854±13.7685.3 (3.2–12.2)NRDMARD-free sustained remissionAge, sex, DAS-44, ACPA ▸ Symptom duration on achieving DMARD-free sustained remission, OR 0.99 (95% CI 0.98 to 1.00), p=0.099
Weng, 201030OC1987+ RA, USA and Mexico23350±13775.7 (0.6–15.9)First appearance of joint symptoms leading to diagnosis of RA ▸ Annual progression rate by total Sharp over 2 years.  ▸ DAS 44<1.6 over 2 years  ▸ Change in HAQ over 2 yearsNone‘Early’ patients (<150 days symptom duration) versus ‘late’ patients (>150 days symptom duration at baseline)  ▸ Total Sharp, units per year 3.13±6.49 vs 1.69±4.43, p=0.3  ▸ 2 year DAS 44<1.6: 25% vs 25%, NS (p NR)  ▸ Δ HAQ −0.61±0.57 vs −0.42±0.68 NS (p NR)
  • ACPA, anti-citrullinated protein antibody; ACR, American College of Rheumatology; CRP, C-reactive protein; DAS, Disease activity score; EAC, early arthritis clinic; ERAS, Early Rheumatoid Arthritis Study group; ESR, erythrocyte sedimentation rate; EULAR, European League Against Rheumatism; FU, follow-up; HAQ, Health assessment questionnaire; HDA, high disease activity; LERA, late early rheumatoid arthritis; NS, Not statistically significant Trend: almost statistically significant; NR, not reported; OC, observational cohort; RCT, randomised controlled trial; RF, rheumatoid factor; SHS, Sharp-van der Heijde Score; TJC, tender joint count; VERA, very early rheumatoid arthritis.