{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T02:36:26Z","timestamp":1790649386813,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2016,7,22]],"date-time":"2016-07-22T00:00:00Z","timestamp":1469145600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011102","name":"European Union Seventh Framework Programme","doi-asserted-by":"crossref","award":["FP7\/2007-2013"],"award-info":[{"award-number":["FP7\/2007-2013"]}],"id":[{"id":"10.13039\/100011102","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100011102","name":"European Union Seventh Framework Programme","doi-asserted-by":"crossref","award":["602919"],"award-info":[{"award-number":["602919"]}],"id":[{"id":"10.13039\/100011102","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Swedish Research Council, the Swedish Council for Health, Working Life and Welfare, the Swedish Rheumatism Association"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the frequency of remaining pain in early rheumatoid arthritis (RA) after 3 months of treatment with methotrexate as the only disease modifying antirheumatic drug, with a special focus on patients with a good clinical response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study base was cases reported to a population\u2010based early RA cohort who had followup data from the Swedish Rheumatology Quality Register (n\u2009=\u20091,241). The Disease Activity Score in 28 joints European League Against Rheumatism (EULAR) response criteria were used to evaluate clinical response to treatment as good, moderate, and no response. The primary end point was remaining pain at the 3\u2010months followup visit, defined as pain &gt;20 mm on a 100\u2010mm visual analog scale (VAS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Remaining pain in spite of a EULAR good response at followup was associated with higher baseline disability, using the Health Assessment Questionnaire (adjusted odds ratio [OR] 2.2 [95% confidence interval (95% CI) 1.4\u20133.4] per unit increase), and less baseline inflammation, using the erythrocyte sedimentation rate (adjusted OR 0.81 [95% CI 0.70\u20130.93] per 10\u2010mm increase). Similar associations were detected for remaining pain at followup in spite of low inflammatory activity, defined as a C\u2010reactive protein level &lt;10. Increase in VAS pain during the treatment period was observed in 19% of the whole cohort, with frequencies in the EULAR response groups of 9% (good response), 15% (moderate response), and 45% (no response).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These results are in line with the hypothesis that a subgroup of early RA patients exhibits pain that is not inflammatory mediated, where alternative treatment strategies to traditional antiinflammatory medications need to be considered.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.22790","type":"journal-article","created":{"date-parts":[[2016,1,19]],"date-time":"2016-01-19T14:40:04Z","timestamp":1453214404000},"page":"1061-1068","source":"Crossref","is-referenced-by-count":107,"title":["Remaining Pain in Early Rheumatoid Arthritis Patients Treated With Methotrexate"],"prefix":"10.1002","volume":"68","author":[{"given":"Reem","family":"Altawil","sequence":"first","affiliation":[{"name":"Karolinska Institute Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saedis","family":"Saevarsdottir","sequence":"additional","affiliation":[{"name":"Karolinska Institute Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Wedr\u00e9n","sequence":"additional","affiliation":[{"name":"Karolinska Institute Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Alfredsson","sequence":"additional","affiliation":[{"name":"Karolinska Institute Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Klareskog","sequence":"additional","affiliation":[{"name":"Karolinska Institute Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Lampa","sequence":"additional","affiliation":[{"name":"Karolinska Institute Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,7,22]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature01661"},{"key":"e_1_2_6_3_1","first-page":"1006","article-title":"Work limitations among working persons with rheumatoid arthritis: results, reliability, and validity of the work limitations questionnaire in 836 patients","volume":"32","author":"Walker N","year":"2005","journal-title":"J Rheumatol"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/147323001003800402"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar3353"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11926-012-0300-4"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.62.9.835"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/03009740903501634"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780310302"},{"key":"e_1_2_6_10_1","first-page":"1674","article-title":"Assessment of pain in rheumatoid arthritis: minimal clinically significant difference, predictors, and the effect of anti\u2010tumor necrosis factor therapy","volume":"34","author":"Wolfe F","year":"2007","journal-title":"J Rheumatol"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.3109\/03009748809098795"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780390105"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21747"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21723"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60944-2"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.27758"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200012)43:12<2751::AID-ANR15>3.0.CO;2-6"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.130493"},{"key":"e_1_2_6_19_1","first-page":"695","article-title":"Severe rheumatoid arthritis (RA), worse outcomes, comorbid illness, and sociodemographic disadvantage characterize RA patients with fibromyalgia","volume":"31","author":"Wolfe F","year":"2004","journal-title":"J Rheumatol"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.24430"},{"issue":"69","key":"e_1_2_6_21_1","first-page":"S104","article-title":"Misdiagnosis in fibromyalgia: a multicentre study","volume":"29","author":"Franco M","year":"2011","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar2842"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199707173370301"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.20303"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.23063"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22282"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2009.05301.x"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar2684"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1053\/eujp.2001.0313"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.37686"},{"key":"e_1_2_6_31_1","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1016\/S0003-4967(24)43386-4","article-title":"What is the fate of erosions in early rheumatoid arthritis? Tracking individual lesions using X rays and magnetic resonance imaging over the first two years of disease","volume":"60","author":"McQueen FM","year":"2001","journal-title":"Ann Rheum Dis"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2011.2"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2011.02.350"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.139212"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.111393"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-12-6"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2005.09.011"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kes356"}],"container-title":["Arthritis Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Facr.22790","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Facr.22790","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.22790","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T17:32:58Z","timestamp":1759426378000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr.22790"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7,22]]},"references-count":37,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2016,8]]}},"alternative-id":["10.1002\/acr.22790"],"URL":"https:\/\/doi.org\/10.1002\/acr.22790","archive":["Portico"],"relation":{},"ISSN":["2151-464X","2151-4658"],"issn-type":[{"value":"2151-464X","type":"print"},{"value":"2151-4658","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7,22]]}}}