{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T07:33:32Z","timestamp":1780731212690,"version":"3.54.1"},"reference-count":23,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"unspecified","delay-in-days":87,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004257","name":"Helse Vest","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004257","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2025,8,11]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To identify subgroups of early rheumatoid arthritis (RA) based on comorbidities and RA manifestations and to investigate their associated risks of cardiovascular events and mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We included patients with incident RA, diagnosed during 2002\u20132013 and followed through 2022. Latent class analysis was performed using 29 variables (excluding age) to identify subgroups 1 year after RA diagnosis. Risk of major cardiovascular events (4p-MACE), death, acute coronary syndrome and stroke was compared between groups using Cox regression adjusting for age and sex.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Four subgroups were identified in a cohort of 873 patients with early RA: a \u2018cardiometabolic\u2019 group (19%), characterised by a high prevalence of cardiovascular disease (CVD) and diabetes; an \u2018elderly-onset\u2019 group (20%), with a high prevalence of polymyalgia rheumatica, anticitrullinated protein antibodies (ACPAs) negativity and less use of disease-modifying antirheumatic drugs (DMARDs); a \u2018classic\u2019 group (26%) with extensive joint involvement and the highest C reactive protein (CRP) levels and a \u2018young-onset\u2019 group (35%) characterised by ACPA positivity and palindromic arthritis.<\/jats:p>\n                  <jats:p>Compared to the \u2018young-onset\u2019 subgroup, both the \u2018cardiometabolic\u2019 (HR 2.14, 95% CI 1.20 to 3.79) and \u2018elderly-onset\u2019 subgroups (HR 1.89, 95% CI 1.07 to 3.35) had increased MACE risk. However, only the \u2018cardiometabolic\u2019 subgroup had increased mortality risk (HR 1.79, 95% CI 1.12 to 2.87).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Four distinct subgroups were identified with different clinical profiles and outcomes. This underscores the feasibility of data-driven classification in early RA. The \u2018cardiometabolic\u2019 and \u2018elderly-onset\u2019 subgroups had similarly high MACE risk, but the latter used less DMARDs, antihypertensives and statins, suggesting undertreatment of both RA and CVD risk factors.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2025-005905","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T10:15:19Z","timestamp":1758881719000},"page":"e005905","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Data-driven identification of subgroups in early rheumatoid arthritis: mortality and cardiovascular disease in a cohort from western Norway"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7131-1592","authenticated-orcid":false,"given":"Christian Lilleb\u00f8","family":"Alsing","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway"},{"name":"Department of Clinical Science, University of Bergen, Bergen, Hordaland, Norway"},{"name":"Department of Heart Disease, Haukeland University Hospital, Bergen, Hordaland, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jannicke","family":"Igland","sequence":"additional","affiliation":[{"name":"Department of Global Public Health and Primary Care, University of Bergen, Bergen, Hordaland, Norway"},{"name":"Department of Health and Social Science, Centre for Evidence-Based Practice, Western Norway University of Applied Sciences, Bergen, Hordaland, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tone Wikene","family":"Nystad","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Haukeland University Hospital, Bergen, Hordaland, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helga","family":"Midtb\u00f8","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, University of Bergen, Bergen, Hordaland, Norway"},{"name":"Department of Heart Disease, Haukeland University Hospital, Bergen, Hordaland, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3584-5738","authenticated-orcid":false,"given":"Eirik","family":"Ikdahl","sequence":"additional","affiliation":[{"name":"REMEDY Center for treatment of Rheumatic and Musculoskeletal Diseases, Diakonhjemmet Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halvor","family":"N\u00e6ss","sequence":"additional","affiliation":[{"name":"Department of Neurology, Haukeland University Hospital, Bergen, Hordaland, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salman","family":"Zarar","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Haukeland University Hospital, Bergen, Hordaland, 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Results from the Swiss prospective observational cohort","volume":"53","author":"Mueller","year":"2014","journal-title":"Rheumatology (Sunnyvale)"},{"key":"2025092603150910000_11.3.e005905.19","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2005.051144"},{"key":"2025092603150910000_11.3.e005905.20","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.170773"},{"key":"2025092603150910000_11.3.e005905.21","doi-asserted-by":"crossref","first-page":"4252","DOI":"10.1093\/rheumatology\/keaa922","article-title":"Effectiveness and safety of treat-to-target strategy in elderly-onset rheumatoid arthritis: a 3-year prospective observational study","volume":"60","author":"Sugihara","year":"2021","journal-title":"Rheumatology (Oxford)"},{"key":"2025092603150910000_11.3.e005905.22","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1111\/1756-185X.12861","article-title":"Comparison of elderly- and young-onset rheumatoid arthritis in an Asian cohort","volume":"20","author":"Tan","year":"2017","journal-title":"Int J Rheum Dis"},{"key":"2025092603150910000_11.3.e005905.23","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1136\/rmdopen-2022-002700","article-title":"Comorbidities and treatment patterns in early rheumatoid arthritis: a nationwide Swedish study","volume":"8","author":"Tidblad","year":"2022","journal-title":"RMD Open"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2025-005905","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T10:15:21Z","timestamp":1758881721000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2025-005905"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":23,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,9,26]]},"published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1136\/rmdopen-2025-005905"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2025-005905","relation":{},"ISSN":["2056-5933"],"issn-type":[{"value":"2056-5933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]}}}