OBJECTIVE To analyze changes in baseline characteristics of patients with very early rheumatoid arthritis (RA) over 24 years in the Early Undifferentiated Polyarthritis (EUPA) cohort. METHODS Consecutive patients with recent-onset polyarthritis fulfilling RA classification criteria recruited in EUPA were assessed at baseline. Three successive periods were defined: (1) prior to the general availability of biologics (1998-2004; 245 patients), (2) prior to the implantation of the 2010 classification criteria (2005-2010; 266 patients), and (3) the most recent decade (2011-2022; 329 patients). RESULTS At baseline, demographics, BMI, swollen and tender joint counts, proportion fulfilling 2010 American College of Rheumatology/European Alliance of Associations for Rheumatology criteria, modified Health Assessment Questionnaire, shared epitope status, patient-reported outcomes except pain, and patient global assessment of disease activity remained stable over the 3 periods. Despite a marked decrease in active smoking (22.2% to 12.1%), prevalence of cardiovascular comorbidities and prior cancer increased. Although duration of symptoms increased from a median of 2.9 to 4.1 months, decreases were seen in seropositivity (53.9% to 42.2%) and C-reactive protein beginning in the 2005-2010 period. A large decrease in erosive status (Sharp/van der Heijde erosion score ≥ 5; 18.3% to 9.4%) was only observed after 2011; this decrease occurred mostly in seronegative patients. Use of disease-modifying antirheumatic drugs prior to inclusion remained low and stable (25.7%), but use of oral corticosteroids increased (18% to 33.4%). CONCLUSION Baseline characteristics of patients with RA evolved since 2005 toward less seropositivity and lower blood inflammation but with more comorbidities. Milder erosive damage at baseline became evident only since 2011, mostly in seronegative patients. These changes at baseline, before any intervention, suggest ongoing secular trends that may favorably affect outcomes in patients with early RA.

中文翻译：

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早期类风湿性关节炎患者的表现变化：早期未分化多关节炎 （EUPA） 队列的 24 年研究。


目的 分析早期未分化多关节炎 （EUPA） 队列中极早期类风湿性关节炎 （RA） 患者 24 年基线特征的变化。方法 在基线时评估在 EUPA 中招募的符合 RA 分类标准的连续近期发作多关节炎患者。确定了三个连续的时期：（1） 生物制剂普遍可用之前（1998-2004 年;245 名患者），（2） 2010 年分类标准植入之前（2005-2010 年;266 名患者），以及 （3） 最近十年（2011-2022 年;329 名患者）。结果在基线时，人口统计学、BMI、肿胀和压痛关节计数、满足 2010 年美国风湿病学会/欧洲风湿病协会联盟标准的比例、改良的健康评估问卷、共享表位状态、患者报告的除疼痛外的结果以及患者对疾病活动的总体评估在 3 个时期保持稳定。尽管主动吸烟率显著下降（22.2% 至 12.1%），但心血管合并症和既往癌症的患病率有所增加。尽管症状持续时间从中位 2.9 个月增加到 4.1 个月，但从 2005-2010 年期间开始，血清阳性 （53.9% 至 42.2%） 和 C 反应蛋白有所下降。侵蚀状况大幅下降（Sharp/van der Heijde 侵蚀评分≥ 5;18.3% 至 9.4%）仅在 2011 年之后观察到;这种减少主要发生在血清阴性患者中。纳入前改善病情的抗风湿药的使用仍然很低且稳定 （25.7%），但口服皮质类固醇的使用增加 （18% 至 33.4%）。结论 RA 患者的基线特征自 2005 年以来朝着血清阳性较低和血液炎症较低但合并症较多的方向发展。 基线时较轻的侵蚀损伤仅在 2011 年后才变得明显，主要发生在血清阴性患者中。在基线时，在进行任何干预之前，这些变化表明持续的长期趋势可能会对早期 RA 患者的结局产生有利影响。