TY - JOUR T1 - Including pain, fatigue and physical function when assessing patients with early rheumatoid arthritis provides a comprehensive picture of disease burden JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.200758 SP - jrheum.200758 AU - Sofia Pazmino AU - Anikó Lovik AU - Annelies Boonen AU - Diederik De Cock AU - Veerle Stouten AU - Johan Joly AU - Delphine Bertrand AU - Kristien van der Elst AU - René Westhovens AU - Patrick Verschueren Y1 - 2020/11/15 UR - http://www.jrheum.org/content/early/2020/11/10/jrheum.200758.abstract N2 - Objective To explore the possibility of integrating patient-important outcomes like pain, fatigue and physical function into the evaluation of disease status in early rheumatoid arthritis (ERA), without compromising correct disease activity measurement. Methods Patients from the 2-year Care-in-early-Rheumatoid-Arthritis (CareRA) trial were included. Pain and fatigue (visual analogue scales), Health Assessment Questionnaire (HAQ), standard components of disease activity (swollen/tender joint counts (SJC/TJC), C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR), Physician (Ph) and Patient's (Pa) global health (GH)) were recorded at every visit (n=10). Pearson correlation and exploratory factor analyses (EFAs), using multiple imputation (15 times) and outputation (1000 times), were performed per timepoint and overall, on standard components of disease activity scores with and without pain, fatigue and HAQ. Each of the 15 000 datasets was analyzed with principal component extraction and oblimin rotation to determine which variables belong together. Results We included 379 patients. EFAs on standard composite score components extracted 2 factors with no substantial cross-loadings. Still, pain (0.83), fatigue (0.65) and HAQ (0.59) were strongly correlated with PaGH. When rerunning the EFAs with the inclusion of pain, fatigue and HAQ, the 2-factor model had substantial cross-loadings between factors. However, a 3-factor model was optimal, with Factor 1: Patient's assessment, Factor 2: Clinical assessment (PhGH, SJC and TJC), and Factor 3: Laboratory (ESR/CRP). Conclusion PaGH, pain, fatigue, and physical function represent a separate aspect of the disease burden of ERA patients, that could be further explored as a target for care apart from disease activity. ER -