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The following is a summary of “Early Rheumatoid Arthritis Patients at Presentation Are Changing: A 24-Year Study of the Early Undifferentiated PolyArthritis (EUPA) Cohort,” published in the September issue of Rheumatology by Carrier et al.

Researchers conducted a retrospective study to examine how the early signs of rheumatoid arthritis (RA) have changed over 24 years in the Early Undifferentiated PolyArthritis (EUPA) cohort.

They assessed patients with recent-onset polyarthritis meeting RA criteria in the EUPA cohort at baseline. The study was divided into 3 periods that were before biologics (1998-2004; 245 patients), before the 2010 criteria (2005-2010; 266 patients), and the most recent decade (2011-2022; 329 patients).

The results showed that at baseline, demographics, BMI, swollen and tender joint counts, proportion fulfilling (2010 ACR⁄EULAR criteria), Modified Health Assessment Questionnaire, shared epitope status, and patient-reported outcomes except pain and Patient Evaluation of Disease Activity stayed stable across periods. Active smoking dropped (22.2% to 12.1%), but cardiovascular comorbidities and prior cancer rose. Symptom duration increased from 2.9 to 4.1 months, with seropositivity dropping (53.9% to 42.2%) and CRP decreasing starting in 2005-2010. Erosive status decreased (Sharp-van der Heijde erosion score ≥5; 18.3% to 9.4%) after 2011, mainly in patients who were seronegative. DMARD use stayed low (25.7%), but oral corticosteroids rose (18.0% to 33.4%).

Investigators concluded that since 2005, patients with RA showed less seropositivity and lower blood inflammation but more comorbidities. Milder erosive damage appeared only after 2011, mostly in patients who were seronegative, hinting at trends that could improve early RA outcomes.

Source: jrheum.org/content/early/2024/09/11/jrheum.2024-0560