{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:02Z","timestamp":1767916802682,"version":"3.49.0"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,3,15]],"date-time":"2019-03-15T00:00:00Z","timestamp":1552608000000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23\u2010AR069688"],"award-info":[{"award-number":["K23\u2010AR069688"]}],"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":["L30\u2010AR066953"],"award-info":[{"award-number":["L30\u2010AR066953"]}],"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":["P30\u2010AR070253"],"award-info":[{"award-number":["P30\u2010AR070253"]}],"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":["P30\u2010AR072577"],"award-info":[{"award-number":["P30\u2010AR072577"]}],"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":["R01\u2010AR049880"],"award-info":[{"award-number":["R01\u2010AR049880"]}],"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":["P30\u2010AR069625"],"award-info":[{"award-number":["P30\u2010AR069625"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ACR Open Rheumatology"],"published-print":{"date-parts":[[2019,3]]},"abstract":"Objective<\/jats:title>To investigate the incidence and predictors of dyspnea on exertion among subjects with rheumatoid arthritis (RA<\/jats:styled-content>).<\/jats:p><\/jats:sec>Methods<\/jats:title>We investigated dyspnea on exertion using a prospective cohort, the Brigham RA<\/jats:styled-content> Sequential Study (BRASS<\/jats:styled-content>). Clinically significant dyspnea on exertion was defined as a score of \u2265 3 (unable to ambulate without breathlessness or worse) on the validated Medical Research Council (MRC<\/jats:styled-content>) scale (range 0\u20105). We analyzed subjects with MRC<\/jats:styled-content> score < 3 at BRASS<\/jats:styled-content> baseline and at \u2265 1 year of follow\u2010up. The MRC<\/jats:styled-content> scale was administered annually. We determined the incidence rate (IR<\/jats:styled-content>) of dyspnea on exertion. We used Cox regression to estimate the hazard ration (HR<\/jats:styled-content>) for dyspnea on exertion occurring one year after potential predictors were assessed.<\/jats:p><\/jats:sec>Results<\/jats:title>We analyzed 829 subjects with RA<\/jats:styled-content> and no clinically significant dyspnea on exertion during a mean follow\u2010up period of 3.0 years (SD<\/jats:styled-content> 1.9). At baseline, mean age was 55.7 years (SD<\/jats:styled-content> 13.6), 82.4% of subjects were female, and median RA<\/jats:styled-content> duration was 8 years. During follow\u2010up, 112 subjects (13.5%) developed incident dyspnea on exertion during 2476 person\u2010years of follow\u2010up (incidence rate 45.2 per 1000 person\u2010years). Independent predictors of incident dyspnea on exertion were older age (HR<\/jats:styled-content> 1.03 per year, 95% CI<\/jats:styled-content>, 1.01\u20101.04), female sex (HR<\/jats:styled-content> 2.22, 95% CI<\/jats:styled-content>, 1.14\u20104.29), mild dyspnea (HR<\/jats:styled-content> 2.62, 95% CI<\/jats:styled-content>, 1.60\u20104.28), and worsened Multi\u2010Dimensional Health Assessment Questionnaire score (HR<\/jats:styled-content> 2.36 per unit, 95% CI<\/jats:styled-content>, 1.54\u20103.60). Methotrexate use, RA<\/jats:styled-content> disease activity, and seropositivity were not associated with incident dyspnea on exertion after accounting for other dyspnea risk factors.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Dyspnea on exertion occurred commonly in patients with RA<\/jats:styled-content>. Older women with impaired physical function were especially vulnerable to developing dyspnea on exertion.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr2.1001","type":"journal-article","created":{"date-parts":[[2019,3,15]],"date-time":"2019-03-15T07:26:16Z","timestamp":1552634776000},"page":"4-15","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Incidence and Predictors of Dyspnea on Exertion in a Prospective Cohort of Patients With Rheumatoid Arthritis"],"prefix":"10.1002","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5556-4618","authenticated-orcid":false,"given":"Jeffrey A.","family":"Sparks","sequence":"first","affiliation":[{"name":"Brigham and Women\u2019s Hospita, Boston, Massachusetts, and Harvard Medical School Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracy J.","family":"Doyle","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospita, Boston, Massachusetts, and Harvard Medical School Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xintong","family":"He","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatrice","family":"Pan","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Iannaccone","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle L.","family":"Frits","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul\u00a0F.","family":"Dellaripa","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospita, Boston, Massachusetts, and Harvard Medical School Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan O.","family":"Rosas","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospita, Boston, Massachusetts, and Harvard Medical School Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bing","family":"Lu","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospita, Boston, Massachusetts, and Harvard Medical School Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael E.","family":"Weinblatt","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospita, Boston, Massachusetts, and Harvard Medical School Boston 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