Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
5 Suppl 31
pubmed:dateCreated
2004-2-18
pubmed:abstractText
Several databases of patients with early rheumatoid arthritis (RA) have been established in the USA. The University of Tennessee at Memphis Cohort was organized in 1967-1971 to enroll 50 young adults (16-44 years) with symptom onset of < or = 6 months who met the 1958 American Rheumatism Association (ARA) criteria for at least probable RA. Two important observations from this database were that many patients seen within the first 6 months of meeting the criteria for probable RA have a self-limited rather than progressive disease, and that progressive disease is predicted by a high number of baseline swollen and tender joints. The National Institutes of Health (NIH) cohort of patients with peripheral synovitis for > or = 6 weeks but < 12 months in at least one peripheral joint was established in 1994. At the one-year follow-up, 45% of the patients met the RA criteria, 9% had reactive arthritis, 6% had psoriatic arthritis, 5% had other rheumatic diseases, and 35% had undifferentiated arthritis. The number of active joints, rather than meeting the criteria for RA, was the primary determinant of function and performance after one year. The Western Consortium of Practicing Rheumatologists (CPR) was established in 1993 to enroll patients with an RA duration < 1 year, positive rheumatoid factor, > or = 6 swollen and > or = 9 tender joints, and no previous treatment with disease modifying anti-rheumatic drugs (DMARDs). Data from this cohort indicated the validity of self-report joint counts. American College of Rheumatology 20% improvement (ACR20) responses were seen in 50% of patients at 6 months and in 57% of patients at 24 months, while antinuclear antibodies (ANA) were seen in 69% of patients prior to the availability of biologic agents. The North American Cohort of Patients with Early RA (SONORA), which included patients with symptoms for > 3 but < 12 months, indicated that methotrexate (MTX) was the most frequently prescribed DMARD, being taken by more than half the patients. The Consortium for the Longitudinal Evaluation of African-Americans with RA (CLEAR) registry and DNA repository has enrolled 123 African-American patients with early RA of less than 2 years' duration to analyze genetic and non-genetic factors associated with disease severity. The Early RA Treatment Evaluation Registry (ERATER) of patients with early RA (< 3 years) was established in 2001. In this registry, MTX was the first DMARD used in 83% of patients, and most patients would not meet the criteria for inclusion in recent clinical trials of biological agents. Further observation of recent cohorts of patients with early RA over the next decade should be informative regarding whether aggressive intervention strategies and new DMARDs and biologic agents lead to improved long-term outcomes.
pubmed:grant
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:issn
0392-856X
pubmed:author
pubmed:issnType
Print
pubmed:volume
21
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
S146-53
pubmed:dateRevised
2007-11-15
pubmed:meshHeading
pubmed-meshheading:14969067-Adolescent, pubmed-meshheading:14969067-Adult, pubmed-meshheading:14969067-Age Distribution, pubmed-meshheading:14969067-Aged, pubmed-meshheading:14969067-Antirheumatic Agents, pubmed-meshheading:14969067-Arthritis, Rheumatoid, pubmed-meshheading:14969067-Cohort Studies, pubmed-meshheading:14969067-Combined Modality Therapy, pubmed-meshheading:14969067-Databases as Topic, pubmed-meshheading:14969067-Disease Progression, pubmed-meshheading:14969067-Female, pubmed-meshheading:14969067-Humans, pubmed-meshheading:14969067-Incidence, pubmed-meshheading:14969067-Male, pubmed-meshheading:14969067-Middle Aged, pubmed-meshheading:14969067-Pain Measurement, pubmed-meshheading:14969067-Physical Therapy Modalities, pubmed-meshheading:14969067-Prognosis, pubmed-meshheading:14969067-Range of Motion, Articular, pubmed-meshheading:14969067-Risk Assessment, pubmed-meshheading:14969067-Severity of Illness Index, pubmed-meshheading:14969067-Sex Distribution, pubmed-meshheading:14969067-United States
pubmed:articleTitle
Databases of patients with early rheumatoid arthritis in the USA.
pubmed:affiliation
Vanderbilt University Medical Center, Nashville, Tennessee, USA.
pubmed:publicationType
Journal Article, Comparative Study, Research Support, U.S. Gov't, P.H.S., Review