title: Effective Treatment for Rapid Improvement of Both Disease Activity and Self-Reported Physical Activity in Early Rheumatoid Arthritis.
abstract: OBJECTIVE
  To investigate the longitudinal relationship between disease activity and self-reported physical activity (PA) in patients with early rheumatoid arthritis during the first year of treatment with combination therapy.
  
  
  METHODS
  PA was measured with the Short Questionnaire to Assess Health-Enhancing Physical Activity at baseline, 13 weeks, 26 weeks, and 52 weeks after start of treatment in the context of the Combinatietherapie Bij Reumatoïde Artritis-Light trial. The reported PA classified patients as meeting or not meeting the World Health Organization (WHO) PA guideline (cutoff: 150 minutes of moderate-to-intense activity per week). Other measurements included the Disease Activity Score (DAS). Since both treatment arms showed equal treatment effect, these were analyzed as 1 group with simple before-after analyses and generalized estimating equations (GEE).
  
  
  RESULTS
  In these analyses, 140 patients (86% of the trial population, 66% women, mean age 52 years) with complete data were included. At entry, 69% of the patients met the WHO PA guideline, increasing to 90% at week 13, and remaining stable at 89% after 1 year (P < 0.001). Mean DAS improved from 4.0 to 1.8 during the first year of treatment (P < 0.001). In GEE analyses, DAS decreases were significantly associated with PA increases (P = 0.008). Patients with clinically relevant responses (expressed as DAS remission, European League Against Rheumatism good response or American College of Rheumatology criteria for 70% improvement response) showed higher PA levels compared to nonresponders, regardless of the definition of response, for both the WHO and Dutch PA guideline.
  
  
  CONCLUSIONS
  Early rheumatoid arthritis patients using combination therapy improved both disease activity and PA, a beneficial effect persisting for at least 1 year.
authors.affiliation: VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Nicole P C
authors.initials: NP
authors.lastname: Konijn
authors.affiliation: VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Lilian H D
authors.initials: LH
authors.lastname: van Tuyl
authors.affiliation: VU University Medical Center and Reade, Amsterdam, The Netherlands.
authors.forename: Maarten
authors.initials: M
authors.lastname: Boers
authors.affiliation: VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Debby
authors.initials: D
authors.lastname: den Uyl
authors.affiliation: VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Marieke M
authors.initials: MM
authors.lastname: Ter Wee
authors.affiliation: Reade, Amsterdam, and Westfriesgasthuis, Hoorn, The Netherlands.
authors.forename: Pit
authors.initials: P
authors.lastname: Kerstens
authors.affiliation: VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Alexandre E
authors.initials: AE
authors.lastname: Voskuyl
authors.affiliation: VU University Medical Center and Reade, Amsterdam, The Netherlands.
authors.forename: Michael
authors.initials: M
authors.lastname: Nurmohamed
authors.affiliation: Reade and Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Dirkjan
authors.initials: D
authors.lastname: van Schaardenburg
authors.affiliation: VU University Medical Center and Reade, Amsterdam, The Netherlands.
authors.forename: Willem F
authors.initials: WF
authors.lastname: Lems
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000628:therapy*; D003131:Combined Modality Therapy; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010789:Phototherapy; D057566:Self Report; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents