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dc.contributor.authorLee, Sook Yan
dc.contributor.authorIbrahim, Fowzia
dc.contributor.authorTom, Brian
dc.contributor.authorNikiphorou, Elena
dc.contributor.authorWilliams, Frances MK
dc.contributor.authorLempp, Heidi
dc.contributor.authorScott, David L
dc.date.accessioned2022-01-06T12:55:32Z
dc.date.available2022-01-06T12:55:32Z
dc.date.issued2021-11-04
dc.identifier.issn1478-6354
dc.identifier.otherPMC8567573
dc.identifier.other34736525
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/332208
dc.description.abstractBACKGROUND: Clinical trials show intensive treatment to induce remission is effective in patients with highly active rheumatoid arthritis (RA). The TITRATE trial showed that the benefits of intensive treatment also extend to moderately active RA. However, many patients failed to achieve remission or show improvements in pain and fatigue. We investigated whether baseline predictors could identify treatment non-responders. METHODS: The impact of obesity, depression, anxiety and illness perception on RA outcomes, including disease activity, remission, pain and fatigue were determined using a pre-planned secondary analysis of the TITRATE trial data. RESULTS: Body mass index was associated with disease activity levels and remission: obese patients had a higher overall disease activity and fewer obese patients achieved remission. Intensive management was not associated with increased remission in these patients. Obesity was also associated with increased overall pain and fatigue. Anxiety, depression and health perceptions had no discernible impact on disease activity but were associated with high levels of pain and fatigue. There was a strong association between anxiety and high pain scores; and between depression and high fatigue scores; and health perception was strongly related to both. None of the predictors had an important impact on pain and fatigue reduction in cross-sectional analysis. CONCLUSIONS: Disease activity is higher in obese patients and they have fewer remissions over 12 months. Anxiety, depression and health perceptions were associated with higher pain and fatigue scores. Intensive management strategies need to account for these baseline features as they impact significantly on clinical and psychological outcomes. TRIAL REGISTRATION: ISRCTN 70160382 ; date registered 16 January 2014.
dc.languageeng
dc.publisherSpringer Science and Business Media LLC
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.sourceessn: 1478-6362
dc.sourcenlmid: 101154438
dc.subjectObesity
dc.subjectRheumatoid arthritis
dc.subjectDepression
dc.subjectPain
dc.subjectFatigue
dc.subjectAnxiety
dc.subjectDisease Activity Score
dc.subjectIntensive Management
dc.subjectHumans
dc.subjectArthritis, Rheumatoid
dc.subjectAntirheumatic Agents
dc.subjectSeverity of Illness Index
dc.subjectCross-Sectional Studies
dc.titleBaseline predictors of remission, pain and fatigue in rheumatoid arthritis: the TITRATE trial.
dc.typeArticle
dc.date.updated2022-01-06T12:55:32Z
prism.issueIdentifier1
prism.publicationNameArthritis Res Ther
prism.volume23
dc.identifier.doi10.17863/CAM.79654
dcterms.dateAccepted2021-10-12
rioxxterms.versionofrecord10.1186/s13075-021-02653-1
rioxxterms.versionVoR
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0/
dc.contributor.orcidLee, Sook Yan [0000-0003-2074-6785]
dc.contributor.orcidTom, Brian [0000-0002-3335-9322]
dc.identifier.eissn1478-6362
pubs.funder-project-idNational Institute for Health Research (NIHR) (RP-PG-0610-10066)
pubs.funder-project-idMedical Research Council (MC_UP_1302/3, MRC_MC_UU_00002/2)
cam.issuedOnline2021-11-04


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Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International