TY - JOUR
T1 - Disease activity and its predictors in early inflammatory arthritis
T2 - findings from a national cohort
AU - Yates, Mark
AU - Ledingham, M
AU - Amlani Hatcher, Paul
AU - Adas, Maryam
AU - Hewitt, Sasha
AU - Bartlett-Pestell, Sam
AU - Rampes, Sanketh
AU - Norton, Sam
AU - Galloway, James B
N1 - Funding Information:
NEIAA is funded by HQIP. The lead author's salary is funded by grants from the British Society for Rheumatology and Versus Arthritis.
Publisher Copyright:
© 2021 The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology.
PY - 2021/10/2
Y1 - 2021/10/2
N2 - Objectives: We set out to characterize patient factors that predict disease activity during the first year of treatment for early inflammatory arthritis (EIA). Methods: We used an observational cohort study design, extracting data from a national clinical audit. All NHS organizations providing secondary rheumatology care in England and Wales were eligible to take part, with recruitment from 215/218 (99%) clinical commissioning groups (CCGs)/Health Boards. Participants were >16 years old and newly diagnosed with RA pattern EIA between May 2018 and May 2019. Demographic details collected at baseline included age, gender, ethnicity, work status and postcode, which was converted to an area level measure of socioeconomic position (SEP). Disease activity scores (DAS28) were collected at baseline, three and 12 months follow-up. Results: A total of 7455 participants were included in analyses. Significant levels of CCG/Health board variation could not be robustly identified from mixed effects modelling. Gender and SEP were predictors of low disease activity at baseline, three and 12 months follow-up. Mapping of margins identified a gradient for SEP, whereby those with higher degrees of deprivation had higher disease activity. Black, Asian and Minority Ethnic patients had lower odds of remission at three months follow-up. Conclusion: Patient factors (gender, SEP, ethnicity) predict disease activity. The rheumatology community should galvanise to improve access to services for all members of society. More data are required to characterize area level variation in disease activity.
AB - Objectives: We set out to characterize patient factors that predict disease activity during the first year of treatment for early inflammatory arthritis (EIA). Methods: We used an observational cohort study design, extracting data from a national clinical audit. All NHS organizations providing secondary rheumatology care in England and Wales were eligible to take part, with recruitment from 215/218 (99%) clinical commissioning groups (CCGs)/Health Boards. Participants were >16 years old and newly diagnosed with RA pattern EIA between May 2018 and May 2019. Demographic details collected at baseline included age, gender, ethnicity, work status and postcode, which was converted to an area level measure of socioeconomic position (SEP). Disease activity scores (DAS28) were collected at baseline, three and 12 months follow-up. Results: A total of 7455 participants were included in analyses. Significant levels of CCG/Health board variation could not be robustly identified from mixed effects modelling. Gender and SEP were predictors of low disease activity at baseline, three and 12 months follow-up. Mapping of margins identified a gradient for SEP, whereby those with higher degrees of deprivation had higher disease activity. Black, Asian and Minority Ethnic patients had lower odds of remission at three months follow-up. Conclusion: Patient factors (gender, SEP, ethnicity) predict disease activity. The rheumatology community should galvanise to improve access to services for all members of society. More data are required to characterize area level variation in disease activity.
UR - http://www.scopus.com/inward/record.url?scp=85117252140&partnerID=8YFLogxK
U2 - 10.1093/rheumatology/keab107
DO - 10.1093/rheumatology/keab107
M3 - Article
C2 - 33537759
SN - 1462-0324
VL - 60
SP - 4811
EP - 4820
JO - Rheumatology
JF - Rheumatology
IS - 10
ER -