Widespread non-joint pain in early rheumatoid arthritis

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Objective: The aim of the study was to assess the development of widespread non-joint pain (WNP) in a cohort of patients with early rheumatoid arthritis (RA), the associated health-related quality of life (HRQoL), and clinical and demographic risk factors for WNP. Method: Incident cases with RA, from the Swedish population-based study Epidemiological Investigation of Rheumatoid Arthritis (EIRA), with a follow-up of at least 3 years, constituted the study population. WNP was defined as pain outside the joints in all four body quadrants and was assessed at the 3 year follow-up. Patients who reported WNP were compared to patients without WNP regarding HRQoL, measured by the Short Form-36, at 3 years, and clinical and demographic characteristics at the time of RA diagnosis. Results: A total of 749 patients constituted the study sample, of whom 25 were excluded after reporting already having severe pain before RA diagnosis. At the 3 year follow-up, 8% of the patients reported having WNP as well as statistically significant worse HRQoL. At the time of RA diagnosis, the patients with WNP had worse pain and pain-related features, while no difference was seen in the inflammatory parameters. Conclusion: WNP occurs in a substantial subset of patients with RA, also early in the course of the disease, and the HRQoL for these patients is significantly reduced. Patients who develop WNP at 3 years are already distinguishable at the time of diagnosis by displaying more pronounced pain ratings together with an average level of inflammatory disease activity.


  • M. E.C. Schelin
  • H. Westerlind
  • J. Lindqvist
  • E. Englid
  • L. Israelsson
  • E. Skillgate
  • L. Klareskog
  • L. Alfredsson
  • J. Lampa
Enheter & grupper
Externa organisationer
  • Region Skåne
  • Karolinska Institute
  • Karolinska University Hospital

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Reumatologi och inflammation
TidskriftScandinavian Journal of Rheumatology
StatusE-pub ahead of print - 2021 feb 25
Peer review utfördJa