Your participation in CATCH has allowed the team to look at a lot of data about people who are diagnosed with early rheumatoid arthritis and look at trends over a long period of time, to see what others like you have in common, or to see the most effective way to treat people with medications. The researchers then present these findings to other researchers at national and international scientific meetings - sometimes they give a talk and other times they will give a poster (at scientific meetings there are dedicated poster sessions where researchers really stand by posters that they've made about their research and findings at certain times and then talk to people who come by to read their posters). Researchers have to 'apply' to present their research and work at meetings, and they do that by creating an 'abstract' which is a shortened version of what they wish to present at a meeting.

All of the CATCH team research abstracts are provided here by year. Each abstract is split in to a 'short' version to give you a simple overview of the research, and if you click on the 'read more' section there is a longer version of the abstract with a few more details for you. If the CATCH team has published a scientific paper on this topic, we have also provided a link to the paper for you. We have tried to use simple language so that you can understand what the researchers did and what they found. You may wish to open our Glossary page beside the abstracts as you read them and we have also linked some more difficult terms directly to the Glossary so you can look up these words as you read (those words are shown in dark red).

If you are interested in reading the full scientific papers that have resulted from CATCH research, you can click here. The attachment provides you with information on all CATCH publications and links to the websites where they are found.

We thank you for your participation in CATCH - none of this research and none of these abstracts would be here without you.


Outcome Measures In Rheumatology (OMERACT): Status On The Flare Assessment Work

S. J. Bartlett1,2. 1Medicine, McGill University, Montreal, Canada; 2Rheumatology, Johns Hopkins, Baltimore, United States

OMERACT (Outcome Measures in Rheumatology) is an international group created in 2006 that works to define and measure RA flares to improve research and patient treatment. OMERACT is made up of researchers, patients, physicians, and people from the pharmaceutical industry. This group has worked on a standard tool to measure RA flares so that no matter who measures it or where it is measured, it is done the same way. The group is also working on a set of questions for patients to help the researchers better understand RA flares.

Read more

What was the purpose of the study?
Since 2006, the OMERACT RA Flare Group has been working to define and measure RA flares to help research and improve patient treatment. The OMERACT RA Flare Group is an international collaboration of rheumatology researchers, clinicians, patients, measurement specialists, and industry partners.

How was the study conducted?
Using methods such as reviewing papers, patient focus groups, patient and healthcare professional exercises, data from studies and voting at OMERACT meetings, this group created a definition for inflammatory RA flares and items to measure. The group is working to develop a standardized RA Flare tool that means no matter who does the measurement or where it is done, it measures flares the same way. The group is using data from different studies in North America and Europe to test their tool.

What are the results?
The goal is to develop an RA Flare Questionnaire that can be used by anyone anywhere measure flares the same way.


Read the paper on this work here.


Radiographic Progression Differs Between Trajectory Clusters Defined By DAS28 Scores in Early Rheumatoid Arthritis

Cheryl Barnabe1, Ye Sun2, Gilles Boire3, Carol Hitchon4, Edward C. Keystone5, J. Carter Thorne6, Boulos Haraoui7, Jeffrey R. Curtis8, De´sire´e van der Heijde9, Diane Tin10, Janet E. Pope11 and Vivian P. Bykerk12. 1University of Calgary, Calgary, AB; 2Mount Sinai Hospital, Toronto, ON; 3CHUS - Sherbrooke University, Sherbrooke, QC; 4University of Manitoba, Winnipeg, MB, 5University of Toronto, Toronto, ON; 6Southlake Regional Health Centre, Newmarket, Newmarket, ON; 7Centre Hospitalier de l’Universite´ de Montréal, Montréal, QC; 8The University of Alabama at Birmingham, Birmingham, AL; 9Leiden University Medical Center, Leiden, Netherlands, 10Southlake Regional Health Centre, Newmarket, ON; 11Western University, London, ON; 12Hospital for Special Surgery, New York, NY.

The CATCH researchers had previously sorted the study participants in to groups (also called clusters) based on their disease activity (measured by DAS28 scores). They also wanted to see if these clusters of patients had patterns with respect to their x-rays (also called radiographic progression). Patients had x-rays taken at the beginning of the study and again 2 years later, and for 43% of patients there was no change in their x-rays. The largest x-ray changes were seen in patients that started with high disease activity and achieved moderate disease activity or began and remained in high disease activity. These findings show the need to understand how a patient may do right from diagnosis and to optimize treatment to prevent joint damage and functional issues.

Read more

What was the purpose of the study?
The CATCH researchers had previously sorted the study participants in to groups (also called clusters) based on their disease activity (measured by DAS28 scores). They also wanted to see if these clusters of patients had patterns with respect to their x-rays (also called radiographic progression).

How was the study done?
Patients were assigned to groups based on their DAS28 scores over 2 years. 601 patients with x-rays taken at the study start and at 2 years were included. X-rays were 'scored' by physicians to put the patients in to groups according to their x-ray findings.

What were the results of the study?
The disease activity clusters were:

  • 27% of patients started with high disease activity and achieved remission;
  • 20% of patients started with moderate or low disease activity and achieved remission;
  • 26% of patients began with moderate disease activity and achieved low disease activity;
  • 22% of patients began in high disease activity and achieved moderate disease activity; and
  • 5% of patients began and remained in high disease activity.

At 2 years, patients who started and remained in high disease activity were more frequently taking biologics (35% of patients) and steroids (38% of patients) but were less frequently on methotrexate only therapy (18%), despite earlier use of DMARD combination therapy relative to other groups.

In terms of x-rays, overall the patients' x-ray average score at the start was 5.3 units with progression of 2.8 units each year and 43% of the patients had no change in x-ray scores in those 2 years. The last 2 clusters of patients (starting in high disease activity and either achieving moderate activity or remaining in high activity) had the worst x-ray progression by 3.6 units per year and 4.4 units per year each respectively. These groups also had the highest numbers of x-ray 'progressors' and the group that had high disease activity over 2 years were very rapid progressors. It is important to determine at diagnosis how a patient will do with their RA, so they can be started on the right therapy to prevent joint damage and keep them functioning well.


Socio-Demographic and Health Status Characteristics Explain Clinical Outcome Trajectories in Early Inflammatory Arthritis

C. Barnabe1, W. T. Huang2, Y. Sun3, G. Boire4, C. A. Hitchon5, E. C. Keystone6, J. C. Thorne7, B. Haraoui8, J. Curtis9, D. Tin7, J. E. Pope10, V. Bykerk11, On behalf of CATCH Investigators. 1Medicine and Community Health Sciences, University of Calgary, Calgary, Canada; 2Hospital for Special Surgery, New York, United States; 3Mount Sinai Hospital, Toronto; 4Université de Sherbrooke, Sherbrooke; 5University of Manitoba, Winnipeg; 6University of Toronto, Toronto; 7Southlake Regional Health Centre, Newmarket; 8Université de Montréal, Montreal, Canada; 9University of Alabama at Birmingham, Birmingham, United States; 10Western University, London; 11Hospital for Special Surgery, New York, United States

The researchers wanted to see what characteristics in people with early inflammatory arthritis would predict the trajectory (another word for course) of their arthritis. For 2 years, 2,215 patients with early arthritis were followed and researchers identified five groups of patients. Researchers broke these groups down by markers in their blood that show disease activity and demographics (for example, age, sex, ethnicity, income, etc.). Patterns in medication use were also seen in these groups. Results show patient demographics need to be considered when determining treatment.

Read more

What was the purpose of the study?
The researchers wanted to see what characteristics of patients with early inflammatory arthritis can be used to help them identify the trajectory (another word for course) of their arthritis, and to see if those characteristics also indicate what types of medications these groups are treated with.

How was this study done?
Based on information in the patients' medical records, groups were identified based on how DAS28 scores changed over time (this measures disease activity).

What were the results of the study?
Five groups were identified in 2,215 patients who were followed for 2 years:

  • Group 1 - this was 24% of patients who started in low disease activity and achieved remission;
  • Group 2 - this was 20% of patients who started in high disease activity and achieved remission;
  • Group 3 - this was 28% of patients who started in moderate disease activity and achieved low disease activity;
  • Group 4 - this was 21% of patients who started in high disease activity and achieved moderate disease activity; and,
  • Group 5 - this was 6% of patients who started and remained in high disease activity.

There were some interesting differences between the groups of patients. For example, in Group 1 (the group who did fairly well in terms of their RA) 56% of patients were positive for rheumatoid factor and 49% were positive for anti-cyclic citrillunated peptide (anti-CCP) while in Group 5 (the group whose RA remained very active over time), 72% of patients were positive for rheumatoid factor and 63% were positive for anti-CCP. On average, patients in Group 1 had a higher income and higher employment rate and fewer comorbidities (that means other illnesses besides RA) compared to Group 5.

Disease course in early inflammatory arthritis is affected by factors like age, sex, other diseases, smoking status, ethnicity, income, and employment. There are also different medication needs based on disease course. The researchers concluded that strategies are needed to address social determinants of health and create tailored treatment approaches for patients.


Subcutaneous Delivery of Methotrexate is Associated with Improved Treatment Survival Compared to Oral Administration for the Initial Treatment of Patients with Early Rheumatoid Arthritis

Glen Hazlewood1, Carter Thorne2, Janet Pope3, Juan Xiong4, Gilles Boire5, Boulos Haraoui6, Carol Hitchon7, Edward Keystone8, Diane Tin9, Vivian Bykerk8. 1University of Calgary, Calgary, AB; 2Southlake Regional Health Centre, The Arthritis Program, Newmarket, ON; 3University of Western Ontario, London, ON; 4The Rebecca MacDonald Center for Arthritis and Autoimmunity, Toronto, ON; 5Université de Sherbrooke, Sherbrooke, QC; 6Université de Montréal, Montréal, QC; 7University of Manitoba, Winnipeg, MB; 8Mount Sinai Hospital, Toronto, ON; 9Southlake Regional Health Centre, Newmarket, ON.

The CATCH researchers wanted to see if it made difference for patients with early RA patients to take methotrexate by pill (called 'oral') or by injection (called 'subcutaneous'). Patients were treated by their rheumatologist and followed every 3 months over the first year. Patients used methotrexate within 3 months of starting the CATCH study and had either never been on methotrexate before or on a very low dose before that. There were 674 patients, 418 took oral methotrexate and 256 took subcutaneous methotrexate. Patients treated with subcutaneous methotrexate were less likely to receive other DMARDs and had a higher starting dose of methotrexate while other characteristics were similar between groups. Patients who started on subcutaneous methotrexate tended to stay on it and did not have many other changes in their DMARDs (if they were on a combination of them) as much as patients who started on oral methotrexate.

Read more

What is the purpose of the study?
The CATCH researchers wanted to see if it made a difference for early RA patients to take methotrexate by pill (called 'oral') versus by injection (called 'subcutaneous').

How was the study done?
Patients were treated by their rheumatologist and followed every 3 months over the first year. Patients used methotrexate within 3 months of starting the CATCH study and had either never been on methotrexate before or on a very low dose before that. There were 674 patients, 418 took oral methotrexate and 256 took subcutaneous methotrexate. The researchers compared what is called the survival between subcutaneous and oral methotrexate over the first year. In this case, the researchers defined treatment failure to be a change in how methotrexate was taken or addition or switch of any DMARDs other than glucocorticoids. The researchers also used statistics to ensure that findings were real.

What were the results of the study?
Patients treated with subcutaneous methotrexate were less likely to receive other DMARDs (56% versus 71%), and had a higher starting dose of methotrexate (23 mg versus 17 mg). Other characteristics were similar between groups. Overall patients appeared to do better who were: taking subcutaneous methotrexate, older in age, and being treated with other DMARDs as well (called combination therapy). The starting dose of methotrexate did not matter. Subcutaneous methotrexate improves survival over oral methotrexate for initial treatment in patients with early RA, meaning that the patients who started on subcutaneous methotrexate had fewer medication changes (including a switch from injected to oral methotrexate) than patients who were on oral methotrexate.

Read the paper on this work here.


The Impact Of Missing Anti-Citrullinated Protein Antibody (ACPA) Serology On Outcomes In Early Rheumatoid Arthritis: Results From Catch (Canadian Early Arthritis Cohort)

J. Shu1, V. Bykerk2, G. Boire3, B. Haraoui4, C. Hitchon5, C. Thorne6, D. Tin6, E. Keystone7, J. Pope1, On behalf of CATCH. 1Division of Rheumatology, Department of Medicine, Western University, London, Canada; 2Department of Rheumatology, Hospital for Special Surgery, Cornell University, New York, United States; 3Division of Rheumatology, Department of Medicine, Université de Sherbrooke, Sherbrooke; 4Department of Rheumatology, Université de Montréal, Montreal; 5Department of Rheumatology, University of Manitoba, Winnipeg; 6Department of Rheumatology, Southlake Regional Health Centre, Newmarket; 7Division of Rheumatology, Department of Medicine, University of Toronto, Toronto

There are 2 markers in a person's blood that can be measured to show that RA is present. They are called rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA). ACPA can be seen earlier in patients with RA and is more specific than RF but ACPA testing is not always done for new patients. In this study, the researchers wanted to see if some RA patients were not diagnosed with RA because ACPA testing was not carried out (usually because the cost is not covered by provincial health plans). Three groups of patients were looked at: 1. seropositive - these patients were RF positive and/or ACPA positive, 2. seronegative  - these patients were RF negative and/or ACPA negative, and, 3. missing ACPA - these patients did not have a measurement done for ACPA and were also RF negative. The researchers found that patients with missing ACPA measures were less likely to be diagnosed with RA and were treated with fewer medications. More studies are needed to make sure that ACPA testing of all new RA patients is worth it.

Read more

What is the purpose of the study?
There are 2 markers in a person's blood that can be measured to show that RA is present. They are called rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA). ACPA can be seen earlier in RA patients and is more specific than RF. ACPA testing is not always carried out in new patients and depends on where you live (it often depends on whether or not your provincial health plan covers the cost of the test). The researchers wanted to see if not measuring ACPA in early inflammatory arthritis patients caused any differences in patient care.

How was the study done?
2191 CATCH patients were placed in to 3 groups based on their RF and ACPA results: 1. Seropositive - these patients were RF positive and/or ACPA positive; 2. Seronegative  - these patients were RF negative and/or ACPA negative); and, 3. Missing ACPA - these patients were missing ACPA measurements and were also RF negative.

What are the results of the study?
Patients with missing ACPA measures were less likely to be considered to have RA and were treated with fewer medications. For example, at 3 months, the group of patients with missing ACPA measurements who were RF negative were treated with less disease modifying anti-rheumatic drugs (DMARDs), but there were no differences in a number of disease activity and overall function measures (including DAS28, HAQ-DI, corticosteroids being taken, or physician global assessment or patient global assessment). The researchers concluded that more studies are needed to determine if it is worth the cost to have all new inflammatory arthritis patients ACPA-tested.

Read the paper on this work here.


The OMERACT Preliminary Flare Questionnaire (PFQ) Is Responsive To Change And Able To Detect Clinically Important Worsening Indicating Need For Treatment Change In The Canadian Early Arthritis Cohort

V. P. Bykerk1, C. O. Bingham III2, E. H. Choy3, G. Boire4, B. P. Haraoui5, D. Lin6, J. E. Pope7, J. Thorne8, C. Hitchon9, D. Tin8, E. C. Keystone6, S. J. Bartlett10, On behalf of OMERACT Flare Group, on behalf of CATCH Investigators. 1Hospital for Special Surgery, Weill Cornell Medical College, New York; 2Johns Hopkins University, Baltimore, United States; 3Cardiff University School of Medicine, Cardiff, United Kingdom; 4Université de Sherbrooke, Sherbrooke; 5Institut de Rhumatologie, Montréal; 6University of Toronto, Toronto; 7University of Western Ontario, London; 8Southlake Regional Health Centre, Newmarket; 9Arthritis Centre, University of Manitoba, Winnipeg; 10McGill University, Montreal

While lots of people with RA have flares, flares are not defined well and they have not been studied very much. Outcome Measures in Rheumatology (OMERACT) is an international group that is made up of scientists, patients, and healthcare providers. A part of this group called the OMERACT RA Flare Group is working together to define what a flare is and how to measure it. This group created a list of questions called the Preliminary Flare Questionnaire to help measure RA flares and tested it with real patient data.

Read more

What is the purpose of the study?
Many patients with RA have flares but these are not well understood or studied. An international group called OMERACT made up of scientists, healthcare providers, and patients, is developing a new tool to measure RA flares that may show these patients' treatments need to change. This group is called the OMERACT RA Flare Group and it has identified an "RA Flare Core Domain Set" (a set of items that will be used to measure the flare). This group evaluated the OMERACT Preliminary Flare Questionnaire (PFQ) to see if they really measured changes in flare using four criteria in a large early RA study.

How was the study conducted?
501 patients in CATCH completed PFQs at two back to back visits to their rheumatologist. The status of a flare was determined using 4 different methods: 1. rheumatologist evaluations, 2. patient evaluations, 3. sensitive disease activity score-based (DAS28) criteria, and 4. specific disease activity score based (DAS28) criteria. In the PFQ, patients rated items on a scale that included their pain, function, fatigue, stiffness, participation in activities and coping over a week.

What are the results?
Patients were mostly female (75%), average age of 55 years, Caucasian (83%), 59% had more than a high school education, and the average RA duration was 6 months. There were differences in what patients and rheumatologists reported on flares. Rheumatologists reported that 148 patients (30%) changed to having a flare between the first and second visits while patients reported that 124 (25%) of them changed to having a flare at the second visit. Using the disease activity score measure, rheumatologists reported that 38 (8%) of patients changed to having a flare between visits while patients said that 58 (13%) changed to a flare between visits. Reliability was measured for flare status and was different between doctor and patient reports or by using the disease activity score measures. Use of medication increased with change to having a flare. No matter which flare classification was used, patients whose flare status changed from one visit to another also saw their PFQ scores change, while patients whose flare status was stable did not change PFQ scores. This means that the PFQ was doing a good job of measuring flares.

The results suggest the PFQ shows changes in flare status in patients with early RA using 4 different flare classifications. Doctor evaluations suggested that more patients changed their flare status while using DAS criteria resulted in fewer patients changing flare status, suggesting this approach is much less sensitive to measuring a change. These results using CATCH patient records increase confidence in OMERACT PFQ being able to detect changes in flare over time in early RA. More studies are needed to know the reliability, validity, and responsiveness of the PFQ across different RA populations and settings before this is widely used.

Read the paper on this work here.


Very Low or High Body Mass Index Negatively Affects Patients’ Ability to Achieve Sustained Remission in Early RA in a Multicenter Canadian Cohort

Susan M. Goodman1, Yan Ma1, Wei Zhang1, Elizabeth Schulman2, Janet E. Pope3, Carol Hitchon4, Susan J. Bartlett5, Boulos Haraoui6, Daming Lin7, Gilles Boire8, Diane Tin9, J. Carter Thorne10, Shahin Jamal11, Edward C. Keystone12 and Vivian P. Bykerk1. 1Hospital for Special Surgery, New York, NY; 2New York Presbyterian - Cornell Campus - HSS, New York, NY; 3St Joseph Health Care, London, ON; 4University of Manitoba, Winnipeg, MB; 5Johns Hopkins University, Baltimore, MD; 6University of Montreal Hospital Centre, Montreal, QC; 7Mount Sinai Hospital, University of Toronto, Toronto, ON; 8CHUS - Sherbrooke University, Sherbrooke, QC; 9Southlake Regional Health Centre, Newmarket, ON; 10Southlake Regional Health Centre, Newmarket, Newmarket, ON; 11Vancouver General Hospital, Vancouver, BC; 12University of Toronto, Toronto, ON.

The CATCH researchers wanted to see if early RA patients with a very low body mass index (BMI) (less than 18.5) or high BMI (great than or equal to 25) are able to achieve sustained remission (REM). BMI is calculated by dividing a person's mass by their height. In 944 patients, their initial BMI and disease activity (measured using the DAS28) were measured over 3 years. Differences between groups were also looked at in terms of patient demographics and outcomes. Sustained REM was defined as having a DAS28 less than 2.6 at two rheumatology visits in a row that were 3 to 12 months apart. The researchers found the chance of achieving sustained remission is lower in underweight, and overweight and/or obese early RA patients, and especially in morbidly obese patients. Early use of methotrexate, an early response to treatment, and being a non-smoker improve a person's chances of achieving sustained remission no matter what their BMI was. BMI should be considered a modifiable risk factor for poor RA outcomes (this means that BMI is something that a patient can control which may help change their overall RA outcomes).

Read more

What was the purpose of the study?
The CATCH researchers wanted to see if early RA patients with a very low body mass index (BMI) (less than 18.5) or high BMI (greater than or equal to 25) are able to achieve sustained remission (REM). BMI is calculated by dividing a person's mass by their height.

How was the study done?
In 944 patients, BMI and disease activity (measured using the DAS28) were measured over 3 years. Patients were then grouped based on World Health Organization BMI classifications (class 1–6) and differences between BMI groups were also looked at in terms of patient demographics and clinical outcomes. Sustained REM was defined as having a DAS28 less than 2.6 at two rheumatology visits in a row that were 3 to 12 months apart.

What were the results of the study?
Only 2% of patients were underweight and 65% were either overweight or obese. Patients with higher BMI were older, more often female with worse physical function at the start of the study, and had higher Patient Global Assessments and pain. Patients with very low or high BMI had a higher C-Reactive Protein and Erythrocyte Sedimentation Rate (this means they had higher levels of inflammation), and patients with low or normal BMI were more often smokers. Variables that were not different among groups included Physician's Global assessments (MDGA), being positive for anti-citrillunated protein antibodies (ACPA) and rheumatoid factor (RF), symptom duration, DAS28 at study start, or steroid or methotrexate use over the first 3 months. Using statistics, it was found that all but one BMI category of patients was less likely to achieve sustained REM compared to normal BMI. Early methotrexate use, not smoking, being Caucasian and achieving a low disease activity state by 6 months increased the chances of achieving sustained REM.

The chance of achieving sustained remission is decreased in underweight, and overweight or obese early RA patients, and especially in the morbidly obese. Early use of methotrexate, an early response to treatment, and being a nonsmoker improve a person's chances of achieving sustained remission no mattter what their BMI. BMI should be considered as a modifiable risk factor for poor RA outcomes (this means that BMI is something that a patient can control which may also help change their overall RA outcomes).


Working Status and Improvements in Work Productivity over Time in an Early Rheumatoid Arthritis (ERA) Cohort

Bindee Kuriya1, Daming Lin2, Cheryl Barnabe3, Gilles Boire4, Boulos Haraoui5, Carol Hitchon6, Shahin Jamal7, J. Carter Thorne8, Diane Tin9, Janet E. Pope10, Edward Keystone11 and Vivian P. Bykerk12. 1University of Toronto, Toronto, ON; 2Mount Sinai Hospital, Toronto, ON; 3University of Calgary, Calgary, AB; 4CHUS - Sherbrooke University, Sherbrooke, QC; 5Centre Hospitalier de l’Universite´ de Montréal, Montréal, QC, 6University of Manitoba, Winnipeg, MB, 7Vancouver Coastal Health, Vancouver, BC, 8Southlake Regional Health Centre, Newmarket, Newmarket, ON; 9Southlake Regional Health Centre, Newmarket, ON; 10Western University, London, ON; 11University of Toronto and Mount Sinai Hospital, Toronto, ON; 12Hospital for Special Surgery, New York, NY.

The CATCH researchers studied how RA affects people who work. 190 study participants completed a questionnaire about work at the beginning of the study and one year later, which showed that 110 of them worked. The researchers looked at how RA affected factors such as work hours missed (called absenteeism) and productivity at work (called presenteeism). In their first year after diagnosis, 78% of participants missed fewer hours of work than before their diagnosis, 67% reported improved productivity and 72% had could do more activities than before. The largest change occurred for absenteeism where people worked on average 9.6 more hours per week after their diagnosis. At one year, factors related to becoming employed again included being younger, being in remission and having higher health assessment questionnaire disability index (HAQ-DI) scores at 6 months. Using DMARDs or biologics at 6 months was not associated with change in work measures but using drugs called corticosteroids affected presenteeism. More studies are needed in larger groups about how RA affects a person's ability to work.

Read more

What was the purpose of the study?
The CATCH researchers studied how RA affects people who work.

How was the study done?
Patients in CATCH who filled in a questionnaire about work called the Work Productivity and Activity Impairment (WPAI) questionnaire at the start of the study and one year were included. For patients who were working at the start of the study, changes in absenteeism (work hours missed) and presenteeism (impact of RA on work productivity) were calculated. The researchers wanted to see if age, sex, symptom duration, disease activity, ability to do everyday tasks (measured by the HAQ-DI) or treatment at six months were associated with improvements seen in the work questionnaire over time.

What were the results of the study?
190 patients were eligible for the study who had filled out work questionnaires, and 110 of those people were working when they entered the study. People not working at the beginning of the study generally had less than high school or college education and lower income, were older, and had moderate-to-high disease activity and higher HAQ-DI scores (this means more disability).

At the one-year point after diagnosis in patients who worked, 78% worked more hours than before their diagnosis, 67% reported improved work productivity and 72% could do more activities than before. The largest change occurred for absenteeism – patients worked on average 9.6 more hours per week one year after their diagnosis. Factors associated with becoming employed by one year after diagnosis included being younger, being in remission, and having a higher HAQ-DI at 6 months. Using DMARDs or biologics at 6 months was not associated with affects on work but using drugs called corticosteroids was associated with presenteeism.

The researchers concluded that there are demographic and disease-related variable differences between ERA patients who are working and those who are not working. The majority of working patients show improvements in work questionnaires over time and the impact of RA's disease activity and a person's functional ability on work requires more studies in a larger number of patients.