{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T16:07:00Z","timestamp":1779379620270,"version":"3.53.1"},"reference-count":34,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K24AR080840"],"award-info":[{"award-number":["K24AR080840"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["RO1AR064850"],"award-info":[{"award-number":["RO1AR064850"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Nonarticular pain (NAP) may contribute to patient global assessment (PtGA), confound disease activity assessment, and influence treatment decisions. Our aims were to (1) evaluate the association between NAP and PtGA in adults with active rheumatoid arthritis (RA) starting a new disease\u2010modifying antirheumatic drug (DMARD) and (2) determine the extent to which this relationship is mediated by pain intensity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We enrolled adults with active RA initiating a new DMARD. Participants indicated NAP on a body pain diagram (0\u201319 sites) and completed assessments of PtGA and pain intensity. To evaluate the association between NAP and PtGA, adjusted multivariable linear regression was performed. Mediation analyses using linear regression models examined whether this association was mediated by pain intensity at baseline and at three months separately. All models were adjusted for potential confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The 197 participants were mostly female (83.8%), with a mean age of 55.1 (SD 14.4) years, a mean disease duration of 10.6 (SD 12.6) years, and a mean Clinical Disease Activity Index score of 23.9 (SD 14.6). NAP was reported by 92.9% at baseline and by 84.8% at three months. At baseline, each site of NAP (0\u201319) was associated with a 0.20\u2010point higher PtGA (\u03b2\u00a0=\u00a00.20, 95% confidence interval 0.12\u20130.28). Pain intensity mediated 61.8% of this association. Similar findings were observed at three months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There was a significant linear relationship between NAP and PtGA, most of which could be explained by pain intensity. These findings raise awareness of NAP and its added burden of worse perceived health status in RA. This may help prevent unnecessary DMARD treatment changes and increase specificity in treatment of different pain types.<\/jats:p>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/acr80081-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.80081","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T13:34:36Z","timestamp":1777901676000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Painful Truth: The Relationship Between Nonarticular Pain and Patient Global Assessment Before and After Initiating a New Disease\u2010Modifying Antirheumatic Drug for Active Rheumatoid Arthritis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9723-5791","authenticated-orcid":false,"given":"Charis","family":"Meng","sequence":"first","affiliation":[{"name":"Hospital for Special Surgery and Weill Cornell Medical College  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8881-9664","authenticated-orcid":false,"given":"Jing","family":"Song","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine  Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lutfiyya N.","family":"Muhammad","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine  Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0046-5452","authenticated-orcid":false,"given":"Burcu","family":"Aydemir","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine  Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia D.","family":"Caci","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9515-1711","authenticated-orcid":false,"given":"Tuhina","family":"Neogi","sequence":"additional","affiliation":[{"name":"Boston Medical Center and Boston University School of Public Health  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5413-9345","authenticated-orcid":false,"given":"Marcy B.","family":"Bolster","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Marder","sequence":"additional","affiliation":[{"name":"University of Michigan  Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4752-5029","authenticated-orcid":false,"suffix":"III,","given":"Clifton O.","family":"Bingham","sequence":"additional","affiliation":[{"name":"Johns Hopkins School of Medicine  Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2105-3393","authenticated-orcid":false,"given":"Yvonne C.","family":"Lee","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine  Chicago 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