Predictors of change in bodily pain in early rheumatoid arthritis: an inception cohort study
Objective: To investigate possible predictors for lack of pain improvement after 1 year of treatment for early rheumatoid arthritis (RA). Methods: The Early Rheumatoid Arthritis Network (ERAN) database was used for analysis of baseline and 1-year pain data. The ERAN is a hospital-based inception...
| Main Authors: | , , , , , |
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| Format: | Article |
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Wiley
2012
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| Online Access: | https://eprints.nottingham.ac.uk/3172/ |
| _version_ | 1848790969195954176 |
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| author | McWilliams, Daniel F. Zhang, Weiya Mansell, Josephine S. Kiely, Patrick D.W. Young, Adam Walsh, David A. |
| author_facet | McWilliams, Daniel F. Zhang, Weiya Mansell, Josephine S. Kiely, Patrick D.W. Young, Adam Walsh, David A. |
| author_sort | McWilliams, Daniel F. |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Objective: To investigate possible predictors for lack of pain improvement after 1 year of treatment for early rheumatoid arthritis (RA).
Methods: The Early Rheumatoid Arthritis Network (ERAN) database was used for analysis of baseline and 1-year pain data. The ERAN is a hospital-based inception cohort of 1,189 people. Short Form 36 questionnaire bodily pain scores were used to calculate change in pain at 1 year as the outcome. The proportion of the Disease Activity Score in 28 joints (DAS28) attributable to patient-reported components (joint tenderness and visual analog scale score; DAS28-P) at baseline was derived as a predictor. Predictors of less improvement in pain were investigated using adjusted odds ratios (ORadj) generated by logistic regression, adjusting for 14 additional clinical and demographic covariates.
Results: Greater pain at baseline was associated with sex, high DAS28, worse mental health, and smoking. Most patients with early RA reported incomplete improvement in bodily pain after 1 year. The DAS28-P index did not significantly change in the patients whose disease remained active. Less improvement in pain was predicted by female sex (ORadj 3.41, 95% confidence interval [95% CI] 1.35–8.64) and a high DAS28-P index at baseline (ORadj for tertiles 2.09, 95% CI 1.24–3.55). Other conventional RA risk factors did not predict pain changes.
Conclusion: The factors most likely to predict less improvement in pain in early RA are female sex and a high DAS28-P index. A high DAS28-P index may reflect greater contributions of noninflammatory factors, such as central sensitization, to pain. Strategies in addition to inflammatory disease suppression may be required to adequately treat pain. |
| first_indexed | 2025-11-14T18:21:03Z |
| format | Article |
| id | nottingham-3172 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T18:21:03Z |
| publishDate | 2012 |
| publisher | Wiley |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-31722020-05-04T16:33:57Z https://eprints.nottingham.ac.uk/3172/ Predictors of change in bodily pain in early rheumatoid arthritis: an inception cohort study McWilliams, Daniel F. Zhang, Weiya Mansell, Josephine S. Kiely, Patrick D.W. Young, Adam Walsh, David A. Objective: To investigate possible predictors for lack of pain improvement after 1 year of treatment for early rheumatoid arthritis (RA). Methods: The Early Rheumatoid Arthritis Network (ERAN) database was used for analysis of baseline and 1-year pain data. The ERAN is a hospital-based inception cohort of 1,189 people. Short Form 36 questionnaire bodily pain scores were used to calculate change in pain at 1 year as the outcome. The proportion of the Disease Activity Score in 28 joints (DAS28) attributable to patient-reported components (joint tenderness and visual analog scale score; DAS28-P) at baseline was derived as a predictor. Predictors of less improvement in pain were investigated using adjusted odds ratios (ORadj) generated by logistic regression, adjusting for 14 additional clinical and demographic covariates. Results: Greater pain at baseline was associated with sex, high DAS28, worse mental health, and smoking. Most patients with early RA reported incomplete improvement in bodily pain after 1 year. The DAS28-P index did not significantly change in the patients whose disease remained active. Less improvement in pain was predicted by female sex (ORadj 3.41, 95% confidence interval [95% CI] 1.35–8.64) and a high DAS28-P index at baseline (ORadj for tertiles 2.09, 95% CI 1.24–3.55). Other conventional RA risk factors did not predict pain changes. Conclusion: The factors most likely to predict less improvement in pain in early RA are female sex and a high DAS28-P index. A high DAS28-P index may reflect greater contributions of noninflammatory factors, such as central sensitization, to pain. Strategies in addition to inflammatory disease suppression may be required to adequately treat pain. Wiley 2012-09-27 Article PeerReviewed McWilliams, Daniel F., Zhang, Weiya, Mansell, Josephine S., Kiely, Patrick D.W., Young, Adam and Walsh, David A. (2012) Predictors of change in bodily pain in early rheumatoid arthritis: an inception cohort study. Arthritis Care & Research, 64 (10). pp. 1505-1513. ISSN 2151-4658 http://onlinelibrary.wiley.com/doi/10.1002/acr.21723/abstract doi:10.1002/acr.21723 doi:10.1002/acr.21723 |
| spellingShingle | McWilliams, Daniel F. Zhang, Weiya Mansell, Josephine S. Kiely, Patrick D.W. Young, Adam Walsh, David A. Predictors of change in bodily pain in early rheumatoid arthritis: an inception cohort study |
| title | Predictors of change in bodily pain in early rheumatoid arthritis: an inception cohort study |
| title_full | Predictors of change in bodily pain in early rheumatoid arthritis: an inception cohort study |
| title_fullStr | Predictors of change in bodily pain in early rheumatoid arthritis: an inception cohort study |
| title_full_unstemmed | Predictors of change in bodily pain in early rheumatoid arthritis: an inception cohort study |
| title_short | Predictors of change in bodily pain in early rheumatoid arthritis: an inception cohort study |
| title_sort | predictors of change in bodily pain in early rheumatoid arthritis: an inception cohort study |
| url | https://eprints.nottingham.ac.uk/3172/ https://eprints.nottingham.ac.uk/3172/ https://eprints.nottingham.ac.uk/3172/ |