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Patient‐Reported Outcome Data From an Early Rheumatoid Arthritis Trial: Opportunities for Broadening the Scope of Treating to Target
Author(s) -
Van der Elst Kristien,
Verschueren Patrick,
Stouten Veerle,
Pazmino Sofia,
De Groef An,
De Cock Diederik,
Joly Johan,
Moons Philip,
Westhovens René
Publication year - 2019
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.23900
Subject(s) - rheumatoid arthritis , scope (computer science) , outcome (game theory) , medicine , intensive care medicine , physical therapy , computer science , economics , mathematical economics , programming language
Objective Treating early, intensively, and to target leads to rapid disease control, preventing joint damage and loss of function in early rheumatoid arthritis ( RA ). We report the effect of such an approach on patient‐reported outcomes and explore the contribution of rapid and persistent disease control to well‐being after 1 year of treatment. Methods This study is part of the Care in Early RA trial, a prospective, 2‐year, investigator‐initiated, randomized controlled trial rooted in daily practice and implementing the treat‐to‐target principle. Short Form 36 ( SF ‐36) health survey and Revised Illness Perception Questionnaire ( IPQ ‐R) data were collected prospectively. We defined 4 clinical response profiles based on speed and consistency of the treatment response within the first year, defined as the Disease Activity Score in 28 joints using the C‐reactive protein level <2.6. Linear regression analyses including these response profiles and treatment type were constructed to predict the SF ‐36 dimensions of vitality, social functioning, role emotional, and mental health, and the IPQ ‐R illness perception subscales of consequences, treatment control, and illness coherence at year 1. Results A total of 333 patients were available for the main analyses, including 140 early persistent responders. Variation in each of the psychosocial outcomes at year 1 was explained mostly by baseline values, followed by the clinical response profiles. Patients with an early persistent response reported significantly higher vitality, more positive beliefs about disease consequences and treatment effect. Treatment type did not matter. Conclusion Rapid and persistent disease control and not treatment type were associated with favorable patient‐reported health and illness perceptions at year 1, but baseline psychosocial variables mattered most. Our data indicate opportunities to broaden the scope of the treat‐to‐target principle in early RA .