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J Rheumatol. 2011 Oct;38(10):2160-8. doi: 10.3899/jrheum.100991. Epub 2011 Aug 1.

Absent "Window of Opportunity" in smokers with short disease duration. Data from BARFOT, a multicenter study of early rheumatoid arthritis.

Author information

1
Address correspondence to Dr. M.K. Söderlin, R&D Center, Spenshult Rheumatology Hospital, SE-313 92, Oskarström, Sweden. maria.soderlin@spenshult.se

Abstract

OBJECTIVE:

To study the effect of disease duration and smoking on outcome in early rheumatoid arthritis (RA).

METHODS:

Between 1996 and 2004, 1587 patients were included in the BARFOT early RA (disease duration ≤ 1 year) study in Sweden. European League Against Rheumatism (EULAR) response, Health Assessment Questionnaire (HAQ), rheumatoid factor (RF), and antibodies to cyclic citrullinated peptide (anti-CCP) were recorded at study start and at 3, 6, and 12 months.

RESULTS:

In total, 180 RA patients (11%) had disease duration ≤ 12 weeks. These patients achieved good EULAR response significantly more often at 3 and 12 months than patients with a longer disease duration despite having more aggressive disease [EULAR good response was achieved by 35% and 35% at 3 and 12 months, respectively, among the patients with disease duration ≤ 12 weeks, by 35% and 41% of patients with disease duration of 13-24 weeks, and by 28% and 33% of patients with disease duration of 25-52 weeks (p = 0.02 for 3 months; p = 0.02 for 12 months)]. There was a significant correlation between improvement in Disease Activity Score-28 (DAS28), its individual variables, and Health Assessment Questionnaire (HAQ) and disease duration up to 12 months after study start. For smokers, no such trend was seen.

CONCLUSION:

Up to 12 months after inclusion in the study, there was a significant correlation between improvement in DAS28, its individual components, and HAQ and disease duration, with patients who had a shorter disease duration improving most. Smokers had poorer EULAR response and showed no improvement with regard to disease duration.

PMID:
21807778
DOI:
10.3899/jrheum.100991
[Indexed for MEDLINE]

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