{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T14:53:57Z","timestamp":1791212037092,"version":"4.1.0"},"reference-count":0,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Rheumatoid arthritis is a heterogeneous disease. Data\u2010driven approaches, from synovial histology to joint involvement patterns (JIPs), have sought to define clinically meaningful subgroups. Whether these subgroups represent stable phenotypes or transient disease states remains unclear. We aimed to develop a novel analytical method to measure longitudinal stability of these subsets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed two randomized controlled trials, NORD\u2010STAR (NOrdic Rheumatic Diseases Strategy Trials And Registries; n=630), BeSt (Behandel\u2010Strategie\u00ebn, n=445) and one real\u2010world cohort (Reumazorg Zuidwest Nederland (RZWN), n=252), all treated with DMARDs under a treat\u2010to\u2010target strategy. Patients were assigned to previously defined JIP\u2010subgroups based on shared clinical features. Disease progression was then tracked over one year along the two principal axes of JIP variation: overall severity (oligoarticular vs. polyarticular) and anatomical distribution (hand vs. foot). Longitudinal stability was assessed by measuring how phenotypically similar each patient remained to others sharing their initial joint pattern, quanitified using silhouette\u2010like scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Effective treatment led to convergence toward mild disease. Nevertheless, patients sharing similar baseline JIPs maintained clustering together over time significantly more than expected by chance in BeSt (\n                      <jats:italic>P<\/jats:italic>\n                      =0.018\u20130.038), NORD\u2010STAR (\n                      <jats:italic>P<\/jats:italic>\n                      =0.004\u20130.017), and RZWN (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001), except for JIP\u2010poly in BeSt and JIP\u2010oligo in NORD\u2010STAR. When stratifying by anatomical region, we found that improvement in foot involvement lagged behind hand involvement across trials.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with similar baseline joint involvement patterns maintain phenotypic similarity over time, suggesting JIP subgroups reflect distinct, stable phenotypes rather than transient disease states. Our tool is available to study the longitudinal stability of any subset.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.80174","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T14:16:02Z","timestamp":1791209762000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patients improve, patterns persist: longitudinal stability of\n                    <scp>RA<\/scp>\n                    joint involvement patterns"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1701-1040","authenticated-orcid":false,"given":"Tjardo","family":"Maarseveen","sequence":"first","affiliation":[{"name":"Department of Rheumatology Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuo","family":"Nagafuchi","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Leiden University Medical Center  Leiden The Netherlands"},{"name":"Division of Rheumatology and Clinical Immunology, Department of Medicine Jichi Medical University  Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5037-5546","authenticated-orcid":false,"given":"Kristina","family":"Lend","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology Amsterdam University Medical Center  Amsterdam The Netherlands"},{"name":"Division of Rheumatology, Department of Medicine, Center for Molecular Medicine (CMM) Karolinska Institute  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyam","family":"Alemyar","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herman Kasper","family":"Glas","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Amphia Ziekenhuis  Breda The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerdur","family":"Gr\u00f6ndal","sequence":"additional","affiliation":[{"name":"Centre for Rheumatology Research Landspitali University Hospital  Reykjavik Iceland"},{"name":"Faculty of Medicine University of Iceland  Reykjavik Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bjorn","family":"Gudbjornsson","sequence":"additional","affiliation":[{"name":"Centre for Rheumatology Research Landspitali University Hospital  Reykjavik Iceland"},{"name":"Faculty of Medicine University of Iceland  Reykjavik Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Espen A.","family":"Haavardsholm","sequence":"additional","affiliation":[{"name":"Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim H\u00f8rslev","family":"Petersen","sequence":"additional","affiliation":[{"name":"Danish Hospital for Rheumatic Diseases University Hospital of Southern Denmark  S\u00f8nderborg Denmark"},{"name":"Department of Regional Health Research University of Southern Denmark  Odense, Syddanmark Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Lampa","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, Center for Molecular Medicine (CMM) Karolinska Institute  Stockholm Sweden"},{"name":"Department of Gastroenterology, Dermatology and Rheumatology Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4229-6818","authenticated-orcid":false,"given":"Merete Lund","family":"Hetland","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopedics, Rigshospitalet  Glostrup Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Nordstr\u00f6m","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Rheumatology Helsinki University Hospital  Helsinki Finland"},{"name":"Department of Medicine University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6274-1934","authenticated-orcid":false,"given":"Mike","family":"Nurmohamed","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology Amsterdam University Medical Center  Amsterdam The Netherlands"},{"name":"Amsterdam Rheumatology and immunology Center, Reade Amsterdam  Noord\u2010Holland The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikkel","family":"\u00d8stergaard","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopedics, Rigshospitalet  Glostrup Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Rudin","sequence":"additional","affiliation":[{"name":"Rheumatology Sahlgrenska University Hospital  Gothenburg Sweden"},{"name":"Department of Rheumatology and Inflammation Research, Institute of Medicine Sahlgrenska Academy  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marte Schrumpf","family":"Heiberg","sequence":"additional","affiliation":[{"name":"Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuulikki","family":"Sokka\u2010Isler","sequence":"additional","affiliation":[{"name":"Rheumatology, Hospital Nova of Wellbeing Services County of Central Finland  Jyv\u00e4skyl\u00e4 Finland"},{"name":"Faculty of Health Sciences University of Eastern Finland  Kuopio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6881-9552","authenticated-orcid":false,"given":"Till","family":"Uhlig","sequence":"additional","affiliation":[{"name":"Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital  Oslo Norway"},{"name":"University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josien Veris\u2010van","family":"Dieren","sequence":"additional","affiliation":[{"name":"Rheumatology clinic, Reumazorg Zuid West Nederland, Van Hertumweg 17\u201019, 4462  EV Goes NL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"van Vollenhoven","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology Amsterdam University Medical Center  Amsterdam The Netherlands"},{"name":"Division of Rheumatology, Department of Medicine, Center for Molecular Medicine (CMM) Karolinska Institute  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Huizinga","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel JT","family":"Reinders","sequence":"additional","affiliation":[{"name":"Pattern Recognition &amp; Bioinformatics Delft University of Technology  Delft The Netherlands"},{"name":"Leiden Computational Biology Center Leiden University Medical Center  Leiden Zuid\u2010Holland NL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7136-5248","authenticated-orcid":false,"given":"Sytske Anne","family":"Bergstra","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"van den Akker","sequence":"additional","affiliation":[{"name":"Pattern Recognition &amp; Bioinformatics Delft University of Technology  Delft The Netherlands"},{"name":"Leiden Computational Biology Center Leiden University Medical Center  Leiden Zuid\u2010Holland NL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7494-3023","authenticated-orcid":false,"given":"Rachel","family":"Knevel","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Leiden University Medical Center  Leiden The Netherlands"},{"name":"Pattern Recognition &amp; Bioinformatics Delft University of Technology  Delft The Netherlands"},{"name":"Newcastle University School of Clinical Medical Sciences  Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,5]]},"container-title":["Arthritis Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.80174","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.80174","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T14:16:02Z","timestamp":1791209762000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr.80174"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,5]]},"references-count":0,"alternative-id":["10.1002\/acr.80174"],"URL":"https:\/\/doi.org\/10.1002\/acr.80174","archive":["Portico"],"relation":{},"ISSN":["2151-464X","2151-4658"],"issn-type":[{"value":"2151-464X","type":"print"},{"value":"2151-4658","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,5]]},"assertion":[{"value":"2026-05-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"acr.80174"}}