ArticleArthritis & rheumatology (Hoboken, N.J.)2017
Twenty-Year Outcome and Association Between Early Treatment and Mortality and Disability in an Inception Cohort of Patients With Rheumatoid Arthritis: Results From the Norfolk Arthritis Register.
Article in Arthritis & rheumatology (Hoboken, N.J.), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it, 73 citations in OpenAlex.
- Imaging tests as predictors of progression to rheumatoid arthritis in clinically suspect arthralgia: a systematic review and meta-analysis.Rheumatology (Oxford, England) · 2025Pooled it
- RhePort 1.3 enhances early identification of inflammatory rheumatic diseases: a prospective study in German rheumatology settings.Rheumatology international · 2025Trial
- Clinical predictors of response to methotrexate in patients with rheumatoid arthritis: a machine learning approach using clinical trial data.Arthritis research & therapy · 2022Trial
- Article
- Development of a Complex Biofeedback-Based Intervention to Improve Methotrexate Adherence in Rheumatoid Arthritis: A COM-B Model Informed Qualitative Study.Patient preference and adherence · 2026Article
- Patient Profile and Outcomes Among Patients with Rheumatoid Arthritis Treated with Baricitinib Versus Other Therapies in Spain: The RA-BE-REAL Study.Rheumatology and therapy · 2025Article
- Survival Outcomes and Prognostic Factors in Rheumatoid Arthritis Patients Receiving Biologic or Targeted Synthetic Therapy: Real-World Data.Antibodies (Basel, Switzerland) · 2025Article
- Quantifying and improving rheumatoid arthritis algorithm performance in biobank settings.Seminars in arthritis and rheumatism · 2025Article
- "As long as you learn to adapt"-a longitudinal mixed-methods study exploring the first decade with rheumatoid arthritis.BMC rheumatology · 2025Article
- DNA and RNA Methylation in Rheumatoid Arthritis-A Narrative Review.Epigenomes · 2025Review
- Relationship between Frailty Assessed Using the Kihon Checklist and Rheumatoid Arthritis.Progress in rehabilitation medicine · 2025Article
- Patient-Reported Outcomes of Depression and Fibromyalgia Symptoms Do Not Predict Non-Inflammatory versus Inflammatory Diagnoses at Initial Rheumatology Consultation.Healthcare (Basel, Switzerland) · 2024Article
- Challenges in implementing treat-to-target in rheumatoid arthritis: a perspective from Brazilian rheumatologists.Advances in rheumatology (London, England) · 2024Article
- Genome-wide investigation of persistence with methotrexate treatment in early rheumatoid arthritis.Rheumatology (Oxford, England) · 2024Article
- Factors Associated with Five-year Deterioration of the Health Assessment Questionnaire-Disability Index in Patients with Rheumatoid Arthritis: A Retrospective Cohort Study.Internal medicine (Tokyo, Japan) · 2023Article
- Influence of Social Support, Financial Status, and Lifestyle on the Disparity Between Inflammation and Disability in Rheumatoid Arthritis.Arthritis care & research · 2023Article
- Can we change the natural course of inflammatory bowel disease?Therapeutic advances in gastroenterology · 2023Review
- Exploring the disparity between inflammation and disability in the 10-year outcomes of people with rheumatoid arthritis.Rheumatology (Oxford, England) · 2022Article
- Influence of initial glucocorticoid co-medication on mortality and hospitalization in early inflammatory arthritis: an investigation by record linkage of clinical and administrative databases.Arthritis research & therapy · 2022Article
- Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
objectiveTo describe the outcome in patients with rheumatoid arthritis (RA) over 20 years from symptom onset, and to assess the association between early treatment (with disease-modifying antirheumatic drugs/steroids) and mortality and disability during follow-up.
methodsPatients recruited to the Norfolk Arthritis Register (NOAR) between 1990 and 1994 who met the 2010 American College of Rheumatology/European League Against Rheumatism RA criteria at baseline were included in this analysis. Demographic and clinical variables were collected at baseline and at years 1-3, 5, 7, 10, 15, and 20. Disease activity (swollen joint count [SJC]/tender joint count [TJC]), disability (Health Assessment Questionnaire disability index [HAQ DI]), and mortality over 20 years were determined. Associations between treatment group (early treatment [ET], treatment ≤6 months after symptom onset; late treatment [LT], treatment >6 months after symptom onset; never treatment [NT], no treatment) and mortality and disability were assessed using weighted pooled logistic regression and weighted multilevel mixed-effects linear regression, respectively. Inverse weights were used to account for confounding by indication and censoring.
resultsThis study included 602 patients with RA (median age 56 years [interquartile range 44-68 years]; 65.9% women). The median SJCs and TJCs were low during the follow-up period (1-3 swollen joints and 3-6 tender joints). The median HAQ DI score increased after year 1 but remained at low/moderate levels (median 1.25 after year 10). The risk of mortality was reduced in the ET and LT groups compared with that in the NT group. The ET group and the NT group had comparable HAQ DI scores during the follow-up period (β = 0.03, 95% confidence interval [95% CI] -0.06, 0.12), while the HAQ DI score was increased in the LT group (for LT versus NT, β = 0.10 [95% CI 0.02, 0.17]).
conclusionThe results of this study indicate the importance of early treatment with regard to the long-term outcomes in patients with RA.
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