Department of Rheumatology, Amsterdam UMC, Academic Medical Center, Amsterdam, The Netherlands.
Department of Rheumatology, Reade, Amsterdam Rheumatology and Immunology Center, Amsterdam, The Netherlands.
Scand J Rheumatol. 2023 Sep;52(5):460-467. doi: 10.1080/03009742.2022.2116806. Epub 2022 Sep 29.
There is a need to better define symptom characteristics associated with arthritis development in individuals at risk of rheumatoid arthritis (RA). We investigated whether reported symptoms in at-risk individuals could predict arthritis development and whether predictive symptoms differed between seropositive and seronegative at-risk individuals.
At-risk individuals from four cohorts (Netherlands, UK, Sweden, and Switzerland) completed the Symptoms in Persons At Risk of Rheumatoid Arthritis (SPARRA) questionnaire. Participants had either (i) anti-citrullinated protein antibodies and/or rheumatoid factor, or (ii) relevant symptoms with or without RA antibodies. Follow up was ≥ 24 months or until clinical arthritis development. Stepwise forward selection created SPARRA prediction models for the combined group and for a seropositive subgroup.
Of 214 participants, the mean age was 50 years, 67% were female, and 27% (n = 58) developed clinical arthritis after a median time of 7 months. Four symptoms predicted arthritis development: self-reported joint swelling, joint pain moving from side to side (combined group only), feeling pins and needles in the joints, and often feeling fatigued (predicting non-arthritis).
Specific symptoms can provide useful information to estimate a person's RA risk. Differences in predictive symptoms between seropositive and seronegative at-risk individuals need to be further investigated. Future research is needed to determine whether changes in symptoms over time improve prediction and to determine the value of SPARRA in optimizing the selection of individuals who need to consult a rheumatologist.
需要更好地定义与类风湿关节炎（RA）风险个体关节炎发展相关的症状特征。我们调查了风险个体报告的症状是否可以预测关节炎的发生，以及预测症状是否在血清阳性和血清阴性的风险个体之间存在差异。
来自四个队列（荷兰、英国、瑞典和瑞士）的风险个体完成了“类风湿关节炎风险个体的症状（SPARRA）”问卷。参与者要么（i）具有抗瓜氨酸化蛋白抗体和/或类风湿因子，要么（ii）具有相关症状，无论是否存在 RA 抗体。随访时间≥24 个月或直至出现临床关节炎。逐步向前选择为合并组和血清阳性亚组创建了 SPARRA 预测模型。
在 214 名参与者中，平均年龄为 50 岁，67%为女性，27%（n=58）在中位数为 7 个月后出现临床关节炎。有 4 个症状可以预测关节炎的发生：自我报告的关节肿胀、关节疼痛从一侧转移到另一侧（仅在合并组中）、关节有刺痛感、经常感到疲劳（预测非关节炎）。
特定的症状可以提供有用的信息来估计一个人患 RA 的风险。血清阳性和血清阴性风险个体之间预测症状的差异需要进一步研究。未来的研究需要确定症状随时间的变化是否可以提高预测能力，并确定 SPARRA 在优化需要咨询风湿病医生的个体选择方面的价值。
