{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T21:40:32Z","timestamp":1790718032589,"version":"4.1.0"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,12,6]],"date-time":"2020-12-06T00:00:00Z","timestamp":1607212800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008021","name":"Bristol-Myers Squibb Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008021","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005565","name":"Janssen Biotech","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005565","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006483","name":"AbbVie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006483","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004312","name":"Eli Lilly and Company","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004312","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010875","name":"Amgen Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010875","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004334","name":"Merck","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004334","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004339","name":"Sanofi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004339","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011110","name":"UCB","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011110","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011218","name":"Sandoz","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011218","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the relationship between disease activity and fatigue over time in early rheumatoid arthritis (RA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were from patients with early RA (duration of symptoms \u226412 months) enrolled in the Canadian Early Arthritis Cohort (CATCH). Patients rated their fatigue over the past week using an 11\u2010point numerical rating scale (NRS) for up to 5 years of follow\u2010up. Fatigue severity was classified as low (\u22642), moderate (&gt;2 but &lt;5), or high (\u22655). Differences in fatigue ratings in patients who achieved a low disease state (Disease Activity Score in 28 joints [DAS28] &lt;3.2) and those who did not within 3\u2010months of cohort entry were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 1,864 patients included, 88% met RA criteria, and 72% were women. The mean \u00b1 SD baseline DAS28 was 4.9 \u00b1 1.5. Nineteen percent of the patients reported moderate baseline fatigue, and 59% reported severe baseline fatigue. Fatigue was correlated with pain and patient global ratings (r = 0.56\u20130.67,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001), and was weakly correlated with DAS28, tender joint count, swollen joint count, physician global assessment of disease activity, erythrocyte sedimentation rate, and C\u2010reactive protein level. Patients who reported low fatigue by 3 months had significantly lower fatigue throughout follow\u2010up compared to those who had moderate or high fatigue at 3 months (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001). Patients who achieved a DAS28 &lt;3.2 within 3 months had significantly lower fatigue ratings (mean \u00b1 SD 2.7 \u00b1 2.6) than those with a DAS28 &gt;3.2 (4.6 \u00b1 3.0) (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001), with improvements in fatigue that persisted through 5 years of follow\u2010up. Maximal improvements in fatigue lagged behind remission by 6 months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Fatigue is common in early RA, and improvements may occur after remission. Early treatment response within 3\u2010months was associated with short\u2010term and long\u2010term benefits in fatigue over time.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/art.41499","type":"journal-article","created":{"date-parts":[[2020,9,2]],"date-time":"2020-09-02T15:17:33Z","timestamp":1599059853000},"page":"53-60","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Improvements in Fatigue Lag Behind Disease Remission in Early Rheumatoid Arthritis: Results From the Canadian Early Arthritis Cohort"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2538-2984","authenticated-orcid":false,"given":"Melissa","family":"Holdren","sequence":"first","affiliation":[{"name":"University of Western Ontario  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orit","family":"Schieir","sequence":"additional","affiliation":[{"name":"University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan J.","family":"Bartlett","sequence":"additional","affiliation":[{"name":"McGill University  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Bessette","sequence":"additional","affiliation":[{"name":"CHU de Qu\u00e9bec\u2010Universit\u00e9 Laval  Laval Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilles","family":"Boire","sequence":"additional","affiliation":[{"name":"Centre Int\u00e9gr\u00e9 Universitaire de Sant\u00e9 et de Services Sociaux de l\u2019Estrie\u2013Centre Hospitalier Universitaire de Sherbrooke and Universit\u00e9 de Sherbrooke  Sherbrooke Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glen","family":"Hazlewood","sequence":"additional","affiliation":[{"name":"University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5547-3268","authenticated-orcid":false,"given":"Carol A.","family":"Hitchon","sequence":"additional","affiliation":[{"name":"University of Manitoba  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6606-0071","authenticated-orcid":false,"given":"Edward","family":"Keystone","sequence":"additional","affiliation":[{"name":"Mount Sinai Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Tin","sequence":"additional","affiliation":[{"name":"Southlake Regional Health Centre  Newmarket Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carter","family":"Thorne","sequence":"additional","affiliation":[{"name":"Southlake Regional Health Centre  Newmarket Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian P.","family":"Bykerk","sequence":"additional","affiliation":[{"name":"Mount Sinai Hospital, Toronto, Ontario, Canada, and Hospital for Special Surgery and Weill Cornell Medicine  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1479-5302","authenticated-orcid":false,"given":"Janet E.","family":"Pope","sequence":"additional","affiliation":[{"name":"University of Western Ontario and St. Joseph's Health Care London  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Canadian Early Arthritis Cohort 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