Abstract
BackgroundThe Scottish Early Rheumatoid Arthritis (SERA) study is an inception cohort of rheumatoid (RA) and undifferentiated arthritis (UA) patients that aims to provide a contemporary description of phenotype and outcome and facilitate discovery of phenotypic and prognostic biomarkersMethodsDemographic and clinical outcome data are collected from newly diagnosed RA/UA patients every 6 months from around Scotland. Health service utilization data is acquired from Information Services Division, NHS National Services Scotland. Plain radiographs of hands and feet are collected at baseline and 12 months. Additional samples of whole blood, plasma, serum and filtered urine are collected at baseline, 6 and 12 monthsResultsResults are available for 1073 patients; at baseline, 76 % were classified as RA and 24 % as UA. Median time from onset to first review was 163 days (IQR97-323). Methotrexate was first-line DMARD for 75 % patients. Disease activity, functional ability and health-related quality of life improved significantly between baseline and 24 months, however the proportion in any employment fell (51 to 38 %, p = 0.0005). 24 % patients reported symptoms of anxiety and/or depression at baseline. 35/391 (9 %) patients exhibited rapid radiographic progression after 12 months. The SERA Biobank has accrued 60,612 samplesConclusionsIn routine care, newly diagnosed RA/UA patients experience significant improvements in disease activity, functional ability and health-related quality of life but have high rates of psychiatric symptoms and declining employment rates. The co-existence of a multi-domain description of phenotype and a comprehensive biobank will facilitate multi-platform translational research to identify predictive markers of phenotype and prognosisElectronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-1318-y) contains supplementary material, which is available to authorized users.
Highlights
The Scottish Early Rheumatoid Arthritis (SERA) study is an inception cohort of rheumatoid (RA) and undifferentiated arthritis (UA) patients that aims to provide a contemporary description of phenotype and outcome and facilitate discovery of phenotypic and prognostic biomarkers
Patients have been recruited from 16 rheumatology departments from 10 Scottish National Health Service (NHS) Health Boards. 1073 patients had complete baseline data available in April 2015
Eightynine healthy controls, comprising first degree relatives or age and sex matched friends, have been recruited. 818 (76 %) of the patients fulfilled the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) Classification Criteria for RA [21] at the baseline assessment, and 255 (24 %) patients were classified as UA
Summary
The Scottish Early Rheumatoid Arthritis (SERA) study is an inception cohort of rheumatoid (RA) and undifferentiated arthritis (UA) patients that aims to provide a contemporary description of phenotype and outcome and facilitate discovery of phenotypic and prognostic biomarkers. Genetic factors account for approximately 60 % of susceptibility to the disease [6], and many single. RA patients have an increased risk of comorbid conditions, including cardiovascular disease, Dale et al BMC Musculoskeletal Disorders (2016) 17:461 infection and depression, and premature mortality [10,11,12,13]. Despite these shared features, RA is a remarkably heterogeneous disorder with a broad spectrum of disease severity, phenotype and responsiveness to treatment resulting in varying prognoses and outcomes. There is increasing evidence of genetic and molecular heterogeneity of RA: for instance, anti-citrullinated protein antibody (ACPA) positive disease is associated with different genetic (e.g. PTPN22) and environmental (e.g. smoking) risk factors when compared to ACPA-negative disease [14], and is associated with a higher rate of radiographic progression [15]
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