Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: It is increasingly recognized that soft tissue inflammation in patients with inflammatory arthritis is frequent and might be of clinical importance. However, when therapeutic adjustments are made, the extent of soft tissue involvement is often not taken into consideration, because it is not measured objectively in disease activity indices. Our study objective was to determine the frequency of soft tissue inflammation such as tenosynovitis, enthesitis, and bursitis in a Canadian cohort of patients presenting with early inflammatory arthritis and to investigate the impact of these manifestations on disease activity, functional ability, quality of life, and self-reported outcome measures.
Methods: Soft tissue prevalence and impact was assessed at baseline in a nationwide cohort of 1509 Canadian adults who were enrolled in the Canadian Early Arthritis Cohort (CATCH) between 2007 and 2012. Disease activity, patient reported outcomes (pain and fatigue), Health Assessment Questionnaire (HAQ), and Short Form quality of life (SF-12) were collected. Soft tissue involvement was assessed by clinical examination.
Results: Our analysis included 1509 patients with a mean age of 54 years old, of whom 73% were women and the mean disease duration until diagnosis was 5.7 months. We found 290 periarticular soft tissue involvement in 222 (14.74%) patients. Periarticular involvement was found in more than one anatomic site in only 59 (26.6) of the 222 patients and in >3 sites, in only 2 (0.9%) patients. The majority of lesions were localized to hands and wrists (56.6%) followed by feet and ankles (16.9%), elbows (11.0%), shoulders (10.4%), hips (3.4%) and knees (1.7%). There was no difference in disease activity score (DAS28), pain, fatigue, function (HAQ), or SF-12 between patients with or without soft tissue disease (Table 1).
Conclusion: The clinical prevalence of soft tissue manifestations in this early inflammatory arthritis cohort was low. The presence of soft tissue involvement was not associated with differences in disease activity indices, patient self-reported symptoms, HAQ, or SF-12. In conclusion, despite the presence of periarticular soft tissue inflammation, current disease activity indices may be sufficient to guide treatment adjustments in this cohort of early inflammatory arthritis.
Table 1. Comparison of patients with and without soft tissue involvement at baseline*
|
|
Patients with soft tissue involvement (n=222) |
Patients without soft tissue involvement (n=1287) |
p |
|
Pain VAS (0-100) (n=1454) |
60.04 (26.83) |
56.14 (28.33) |
NS |
|
Fatigue VAS (0-100) (n=1479) |
52.84 (30.28) |
56.3 (29.42)
|
NS |
|
DAS28 (0-9.4) (n=1387) |
5.04 (1.44)
|
5.19 (1.38)
|
NS |
|
CDAI (0-76) (n=1449) |
27.05 (14.04)
|
28.02 (1.38)
|
NS |
|
SDAI (0-86) (n=1333) |
28.31 (14.69) |
29.55 (14.76)
|
NS |
|
HAQ (0-3) (n=1484) |
1.03 (0.71) |
1.09 (0.69)
|
NS |
|
SF-12 (physical score) (0-5) (n=1346) |
3.66 (1.06) |
3.55 (9.57) |
NS |
|
SF-12 (mental score) (0-5) (n=1346) |
4.54 (1.58) |
4.58 (1.18) |
NS |
*Values are presented as means and SD
Disclosure:
M. Popescu,
None;
E. Villeneuve,
None;
B. Haraoui,
None;
G. Boire,
None;
C. A. Hitchon,
None;
E. C. Keystone,
None;
J. E. Pope,
None;
J. C. Thorne,
None;
D. Tin,
None;
V. P. Bykerk,
None.
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