RESEARCH - Morning stiffness in patients with early RA associated more strongly with functional disability than with joint swelling and ESR

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J Rheumatol. 2004 Sep;31(9):1723-6.

Morning stiffness in patients with early rheumatoid arthritis is

associated more strongly with functional disability than with joint

swelling and erythrocyte sedimentation rate.

Yazici Y, Kautiainen H, Sokka T.

Brooklyn Heights Arthritis Associates, Long Island College Hospital,

Brooklyn, New York, USA.

OBJECTIVE: To compare the level of morning stiffness in a cohort of

patients with early rheumatoid arthritis (RA), assessed on a self-report

questionnaire, to levels of patient self-report scores and clinical and

laboratory variables. METHODS: A total of 337 patients with recent onset

RA since 1998 were assessed for tender and swollen joint counts,

erythrocyte sedimentation rate (ESR), physician global assessment, and

radiographs of the hands and feet, as well as Multidimensional Health

Assessment Questionnaire (MDHAQ) scores for functional disability, pain,

fatigue, global status, morning stiffness, and number of symptoms.

Regression models were used to estimate possible associations between

these variables and morning stiffness. RESULTS: At study entry, 70

patients (21%) reported no morning stiffness, 52 (15%) reported morning

stiffness < 15 minutes, 52 (15%) for 16-59 minutes, and 163 (49%) for

>/= 1 one hour. At baseline and in longitudinal analyses, morning

stiffness was significantly associated with functional disability scores

on the MDHAQ and with other patient self-report data, and was associated

at lower levels with swollen and tender joint counts and erythrocyte

sedimentation rate (ESR).

CONCLUSION: The degree of morning stiffness appears to reflect

functional disability and pain more than traditional markers of

inflammation such as joint counts and ESR in patients with early RA.

Inclusion of morning stiffness as a marker of inflammatory activity in

classification criteria for RA, inclusion criteria for most clinical

trials in RA, and RA remission criteria, may be open to reassessment.

PMID: 15338490 [

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

5338490 & dopt=Abstract

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