Clinical significance of a self-reported familial occurrence of rheumatoid arthritis among patients with recent-onset arthritis: data from the ESPOIR cohort
D. Guellec1, G. Carvajal-Alegria2, C. Daïen3, L. Gossec4, F. Guillemin5, F. Berenbaum6, A. Constantin7, P. Dieude8, M. Dougados9, R.M. Flipo10, P. Goupille11, X. Mariette12, C. Richez13, O. Vittecoq14, B. Combe15, A. Saraux16
- CHU de Brest, Rheumatology Department, Brest, and 2Inserm, CIC 1412, Brest, France.
- CHU de Brest, Rheumatology Department, Brest, and UMR1227, Lymphocytes B et Autoimmunité INSERM, Université de Bretagne occidentale (UBO), Brest, France.
- Département de Rhumatologie, CHU Montpellier; IGMM-UMR5535, Montpellier and Montpellier University, France.
- Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, and Pitié-Salpêtrière Hospital, AP-HP, Sorbonne Université, Rheumatology Department, Paris, France.
- EA 4360 APEMAC, Université de Lorraine, Nancy, France.
- Department of Rheumatology, Sorbonne Université, Inserm CRSA, AP-HP Saint-Antoine Hospital, Paris France.
- Rheumatology, CHU Purpan, Toulouse University, France.
- Department of Rheumatology, Assistance Publique-Hôpitaux de Paris, Bichat-Claude Bernard University Hospital, Paris, INSERM UMR1152, University of Paris, France.
- Université de Paris, Department of Rheumatology, Hôpital Cochin; Assistance Publique, Hôpitaux de Paris INSERM (U1153): Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France.
- Service de Rhumatologie, Hôpital Roger Salengro, Université de Lille, France.
- Service de Rhumatologie et CIC1415, CHU de Tours; EA 7501, Université de Tours, France.
- Department of Rheumatology, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Sud, INSERM UMR1184, Le Kremlin Bicêtre, France.
- Rheumatology Department, Centre Hospitalier Universitaire de Bordeaux, FHU ACRONIM, Service de Rhumatologie, Bordeaux, France.
- Department of Rheumatology, Rouen University Hospital, Rouen, France.
- Montpellier University, Montpellier, France.
- CHU de Brest, Rheumatology Department, Brest, and UMR1227, Lymphocytes B et Autoimmunité INSERM, Université de Bretagne occidentale (UBO), Brest, France. email@example.com
2023 Vol.41, N°3
PI 0649, PF 0655
PMID: 35894071 [PubMed]
Accepted : 16/05/2022
In Press: 21/07/2022
To assess, in patients with recent-onset arthritis, whether a self-reported familial occurrence of rheumatoid arthritis (RA) is associated with a clinical presentation of the disease, final diagnosis, long-term outcome and treatment decisions.
The study was conducted from data of patients included between 2002 and 2005 in the early arthritis ESPOIR cohort. Patients were recruited on the basis of having at least two swollen joints for >6 weeks and <6 months, no other diagnosis than RA and no previous exposure to glucocorticoids or disease-modifying antirheumatic drugs (DMARDs). Patients were stratified into two groups according to the presence of a self-reported familial occurrence of RA at baseline. Data concerning final diagnosis (2-year visit), long-term outcome (5-year visit) and therapeutic decisions were compared between the 2 groups of patients, using logistic and Cox regression models.
At baseline, 115 patients (14.1%) reported a familial occurrence of RA and showed, as compared with the remaining participants, higher prevalence of extra articular manifestations (EAMs) (51.8% vs. 39.6%, p=0.01) and severe EAMs (7.9% vs. 3.1%, p 0.01). Both unadjusted (hazard ratio, 1.57; 95% CI, 1.1–2.21; p = 0.01) and adjusted analysis (hazard ratio, 1.51; 95% CI, 1.06–2.15; p=0.02) identified a higher probability for the initiation of a targeted DMARD over time among patients with a self-reported familial occurrence of RA.
In the specific context of early arthritis, a self-reported familial occurrence of RA is associated with the future decision to initiate a targeted DMARD.