{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T13:44:08Z","timestamp":1782395048511,"version":"3.54.5"},"reference-count":47,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,11,4]],"date-time":"2021-11-04T00:00:00Z","timestamp":1635984000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,4]],"date-time":"2021-11-04T00:00:00Z","timestamp":1635984000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"crossref","award":["RP-PG-0610-10066"],"award-info":[{"award-number":["RP-PG-0610-10066"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arthritis Res Ther"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Clinical trials show intensive treatment to induce remission is effective in patients with highly active rheumatoid arthritis (RA). The TITRATE trial showed that the benefits of intensive treatment also extend to moderately active RA. However, many patients failed to achieve remission or show improvements in pain and fatigue. We investigated whether baseline predictors could identify treatment non-responders.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The impact of obesity, depression, anxiety and illness perception on RA outcomes, including disease activity, remission, pain and fatigue were determined using a pre-planned secondary analysis of the TITRATE trial data.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Body mass index was associated with disease activity levels and remission: obese patients had a higher overall disease activity and fewer obese patients achieved remission. Intensive management was not associated with increased remission in these patients. Obesity was also associated with increased overall pain and fatigue. Anxiety, depression and health perceptions had no discernible impact on disease activity but were associated with high levels of pain and fatigue. There was a strong association between anxiety and high pain scores; and between depression and high fatigue scores; and health perception was strongly related to both. None of the predictors had an important impact on pain and fatigue reduction in cross-sectional analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Disease activity is higher in obese patients and they have fewer remissions over 12 months. Anxiety, depression and health perceptions were associated with higher pain and fatigue scores. Intensive management strategies need to account for these baseline features as they impact significantly on clinical and psychological outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.isrctn.com\/ISRCTN70160382\">ISRCTN 70160382<\/jats:ext-link>; date registered 16 January 2014<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13075-021-02653-1","type":"journal-article","created":{"date-parts":[[2021,11,4]],"date-time":"2021-11-04T06:02:47Z","timestamp":1636005767000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Baseline predictors of remission, pain and fatigue in rheumatoid arthritis: the TITRATE trial"],"prefix":"10.1186","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2074-6785","authenticated-orcid":false,"given":"Sook Yan","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fowzia","family":"Ibrahim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian D. M.","family":"Tom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Nikiphorou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances M. K.","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Lempp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L.","family":"Scott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,11,4]]},"reference":[{"issue":"5","key":"2653_CR1","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1016\/j.berh.2007.05.006","volume":"21","author":"DL Scott","year":"2007","unstructured":"Scott DL, Steer S. The course of established rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2007;21(5):943\u201367.","journal-title":"Best Pract Res Clin Rheumatol"},{"issue":"1","key":"2653_CR2","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1186\/s12891-018-2302-5","volume":"19","author":"CD Hughes","year":"2018","unstructured":"Hughes CD, Scott DL, Ibrahim F. Intensive therapy and remissions in rheumatoid arthritis: a systematic review. BMC Musculoskelet Disord. 2018;19(1):389.","journal-title":"BMC Musculoskelet Disord"},{"issue":"1","key":"2653_CR3","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1186\/s13063-017-2330-8","volume":"18","author":"NH Martin","year":"2017","unstructured":"Martin NH, Ibrahim F, Tom B, Galloway J, Wailoo A, Tosh J, et al. Does intensive management improve remission rates in patients with intermediate rheumatoid arthritis? (the TITRATE trial): study protocol for a randomised controlled trial. Trials. 2017;18(1):591.","journal-title":"Trials"},{"key":"2653_CR4","first-page":"1182","volume-title":"Seminars in arthritis and rheumatism: 2020","author":"D Scott","year":"2020","unstructured":"Scott D, Ibrahim F, Hill H, Tom B, Prothero L, Baggott RR, et al. The clinical effectiveness of intensive management in moderate established rheumatoid arthritis: the titrate trial. In:  Seminars in arthritis and rheumatism: 2020: Elsevier; 2020. p. 1182\u201390."},{"issue":"7","key":"2653_CR5","doi-asserted-by":"publisher","first-page":"1194","DOI":"10.1093\/rheumatology\/key066","volume":"57","author":"E Nikiphorou","year":"2018","unstructured":"Nikiphorou E, Norton S, Young A, Dixey J, Walsh D, Helliwell H, et al. The association of obesity with disease activity, functional ability and quality of life in early rheumatoid arthritis: data from the early rheumatoid arthritis Study\/early rheumatoid arthritis network UK prospective cohorts. Rheumatology. 2018;57(7):1194\u2013202.","journal-title":"Rheumatology"},{"issue":"2","key":"2653_CR6","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1093\/rheumatology\/kev306","volume":"55","author":"F Matcham","year":"2016","unstructured":"Matcham F, Norton S, Scott DL, Steer S, Hotopf M. Symptoms of depression and anxiety predict treatment response and long-term physical health outcomes in rheumatoid arthritis: secondary analysis of a randomized controlled trial. Rheumatology (Oxford, England). 2016;55(2):268\u201378.","journal-title":"Rheumatology (Oxford, England)"},{"issue":"9","key":"2653_CR7","doi-asserted-by":"publisher","first-page":"1580","DOI":"10.1136\/ard.2010.138461","volume":"69","author":"D Aletaha","year":"2010","unstructured":"Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd, et al. Rheumatoid arthritis classification criteria: an American College of Rheumatology\/European league against rheumatism collaborative initiative. Ann Rheum Dis. 2010;69(9):1580\u20138.","journal-title":"Ann Rheum Dis"},{"issue":"8","key":"2653_CR8","doi-asserted-by":"publisher","first-page":"1348","DOI":"10.1093\/rheumatology\/kev379","volume":"55","author":"S Georgopoulou","year":"2016","unstructured":"Georgopoulou S, Prothero L, Lempp H, Galloway J, Sturt J. Motivational interviewing: relevance in the treatment of rheumatoid arthritis? Rheumatology (Oxford, England). 2016;55(8):1348\u201356.","journal-title":"Rheumatology (Oxford, England)"},{"issue":"2","key":"2653_CR9","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1111\/hex.12457","volume":"20","author":"L Prothero","year":"2017","unstructured":"Prothero L, Georgopoulou S, de Souza S, Bosworth A, Bearne L, Lempp H. Patient involvement in the development of a handbook for moderate rheumatoid arthritis. Health Expect. 2017;20(2):288\u201397.","journal-title":"Health Expect"},{"issue":"1","key":"2653_CR10","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/s41927-019-0057-8","volume":"3","author":"L Prothero","year":"2019","unstructured":"Prothero L, Sturt J, de Souza S, Lempp H, Lempp H, Sturt J, et al. Intensive management for moderate rheumatoid arthritis: a qualitative study of patients\u2019 and practitioners\u2019 views. BMC Rheumatol. 2019;3(1):12.","journal-title":"BMC Rheumatol"},{"issue":"8","key":"2653_CR11","first-page":"1674","volume":"34","author":"F Wolfe","year":"2007","unstructured":"Wolfe F, Michaud K. Assessment of pain in rheumatoid arthritis: minimal clinically significant difference, predictors, and the effect of anti-tumor necrosis factor therapy. J Rheumatol. 2007;34(8):1674\u201383.","journal-title":"J Rheumatol"},{"issue":"12","key":"2653_CR12","doi-asserted-by":"publisher","first-page":"2339","DOI":"10.3899\/jrheum.080375","volume":"35","author":"D Khanna","year":"2008","unstructured":"Khanna D, Pope JE, Khanna PP, Maloney M, Samedi N, Norrie D, et al. The minimally important difference for the fatigue visual analog scale in patients with rheumatoid arthritis followed in an academic clinical practice. J Rheumatol. 2008;35(12):2339\u201343.","journal-title":"J Rheumatol"},{"issue":"9","key":"2653_CR13","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","volume":"16","author":"K Kroenke","year":"2001","unstructured":"Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606\u201313.","journal-title":"J Gen Intern Med"},{"issue":"10","key":"2653_CR14","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","volume":"166","author":"RL Spitzer","year":"2006","unstructured":"Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092\u20137.","journal-title":"Arch Intern Med"},{"issue":"6","key":"2653_CR15","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1016\/j.jpsychores.2005.10.020","volume":"60","author":"E Broadbent","year":"2006","unstructured":"Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res. 2006;60(6):631\u20137.","journal-title":"J Psychosom Res"},{"issue":"3","key":"2653_CR16","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1002\/mpr.150","volume":"12","author":"IR White","year":"2003","unstructured":"White IR, Moodie E, Thompson SG, Croudace T. A modelling strategy for the analysis of clinical trials with partly missing longitudinal data. Int J Methods Psychiatr Res. 2003;12(3):139\u201350.","journal-title":"Int J Methods Psychiatr Res"},{"key":"2653_CR17","volume-title":"Release 16","author":"StataCorp","year":"2019","unstructured":"StataCorp. Stata statistical software. In:  Release 16. College Station: StataCorp LLC; 2019."},{"issue":"8","key":"2653_CR18","doi-asserted-by":"publisher","first-page":"1916","DOI":"10.1093\/rheumatology\/kez535","volume":"59","author":"M Sch\u00e4fer","year":"2020","unstructured":"Sch\u00e4fer M, Mei\u00dfner Y, Kekow J, Berger S, Remstedt S, Manger B, et al. Obesity reduces the real-world effectiveness of cytokine-targeted but not cell-targeted disease-modifying agents in rheumatoid arthritis. Rheumatology. 2020;59(8):1916\u201326.","journal-title":"Rheumatology"},{"key":"2653_CR19","first-page":"976","volume-title":"Seminars in arthritis and rheumatism: 2019","author":"L Baganz","year":"2019","unstructured":"Baganz L, Richter A, Albrecht K, Schneider M, Burmester G-R, Zink A, et al. Are prognostic factors adequately selected to guide treatment decisions in patients with rheumatoid arthritis? A collaborative analysis from three observational cohorts. In:  Seminars in arthritis and rheumatism: 2019: Elsevier; 2019. p. 976\u201382."},{"issue":"9","key":"2653_CR20","doi-asserted-by":"publisher","first-page":"1601","DOI":"10.1093\/rheumatology\/kew210","volume":"55","author":"MJ Cook","year":"2016","unstructured":"Cook MJ, Diffin J, Scire CA, Lunt M, MacGregor AJ, Symmons DP, et al. Predictors and outcomes of sustained, intermittent or never achieving remission in patients with recent onset inflammatory polyarthritis: results from the Norfolk arthritis register. Rheumatology. 2016;55(9):1601\u20139.","journal-title":"Rheumatology"},{"key":"2653_CR21","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.ejim.2019.05.017","volume":"66","author":"M Di Carlo","year":"2019","unstructured":"Di Carlo M, Salaffi F, Gremese E, Iannone F, Lapadula G, Ferraccioli G, et al. Body mass index as a driver of selection of biologic therapy in rheumatoid arthritis. Results from the US-CLARA study. Eur J Intern Med. 2019;66:57\u201361.","journal-title":"Eur J Intern Med"},{"issue":"12","key":"2653_CR22","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.1111\/eci.12691","volume":"46","author":"A Gardette","year":"2016","unstructured":"Gardette A, Ottaviani S, Sellam J, Berenbaum F, Liot\u00e9 F, Fautrel B, et al. Body mass index and response to abatacept in rheumatoid arthritis. Eur J Clin Investig. 2016;46(12):1048\u201352.","journal-title":"Eur J Clin Investig"},{"issue":"4","key":"2653_CR23","doi-asserted-by":"publisher","first-page":"857","DOI":"10.1007\/s10067-016-3183-3","volume":"35","author":"A Gardette","year":"2016","unstructured":"Gardette A, Ottaviani S, Sellam J, Berenbaum F, Liot\u00e9 F, Meyer A, et al. Body mass index and response to tocilizumab in rheumatoid arthritis: a real life study. Clin Rheumatol. 2016;35(4):857\u201361.","journal-title":"Clin Rheumatol"},{"issue":"1","key":"2653_CR24","first-page":"49","volume":"37","author":"J Goossens","year":"2019","unstructured":"Goossens J, Coustet B, Palazzo E, Dieud\u00e9 P, Ottaviani S. Overweight and obesity affect clinical assessment of synovitis in rheumatoid arthritis: comparison of ultrasonography and clinical exam. Clin Exp Rheumatol. 2019;37(1):49\u201354.","journal-title":"Clin Exp Rheumatol"},{"issue":"3","key":"2653_CR25","first-page":"422","volume":"37","author":"CB McCulley","year":"2019","unstructured":"McCulley CB, Barton JL, Cannon GW, Sauer BC, Teng CC, George MD, et al. Body mass index and persistence of conventional DMARDs and TNF inhibitors in rheumatoid arthritis. Clin Exp Rheumatol. 2019;37(3):422\u20138.","journal-title":"Clin Exp Rheumatol"},{"issue":"6","key":"2653_CR26","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1016\/j.jbspin.2015.02.011","volume":"82","author":"S Ottaviani","year":"2015","unstructured":"Ottaviani S, Gardette A, Roy C, Tubach F, Gill G, Palazzo E, et al. Body mass index and response to rituximab in rheumatoid arthritis. Joint Bone Spine. 2015;82(6):432\u20136.","journal-title":"Joint Bone Spine"},{"issue":"11","key":"2653_CR27","doi-asserted-by":"publisher","first-page":"2029","DOI":"10.1136\/annrheumdis-2013-205094","volume":"73","author":"ME Sandberg","year":"2014","unstructured":"Sandberg ME, Bengtsson C, K\u00e4llberg H, Wesley A, Klareskog L, Alfredsson L, et al. Overweight decreases the chance of achieving good response and low disease activity in early rheumatoid arthritis. Ann Rheum Dis. 2014;73(11):2029\u201333.","journal-title":"Ann Rheum Dis"},{"issue":"3","key":"2653_CR28","doi-asserted-by":"publisher","first-page":"215","DOI":"10.2174\/1573397115666181130143239","volume":"15","author":"T Sapundzhieva","year":"2019","unstructured":"Sapundzhieva T, Karalilova R, Batalov A. Body mass index impact on disease activity, clinical and sonographic remission rates in patients with rheumatoid arthritis. Curr Rheumatol Rev. 2019;15(3):215\u201323.","journal-title":"Curr Rheumatol Rev"},{"issue":"8","key":"2653_CR29","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1002\/acr.23457","volume":"70","author":"E Schulman","year":"2018","unstructured":"Schulman E, Bartlett SJ, Schieir O, Andersen KM, Boire G, Pope JE, et al. Overweight, obesity, and the likelihood of achieving sustained remission in early rheumatoid arthritis: results from a multicenter prospective cohort study. Arthr Care Res. 2018;70(8):1185\u201391.","journal-title":"Arthr Care Res"},{"issue":"4","key":"2653_CR30","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1007\/s10067-016-3505-5","volume":"36","author":"F Iannone","year":"2017","unstructured":"Iannone F, Courvoisier DS, Gottenberg JE, Hernandez MV, Lie E, Canh\u00e3o H, et al. Body mass does not impact the clinical response to intravenous abatacept in patients with rheumatoid arthritis.\u00a0Analysis from the \"pan-European registry collaboration for abatacept (PANABA)\". Clin Rheumatol. 2017;36(4):773\u20139.","journal-title":"Clin Rheumatol."},{"issue":"1","key":"2653_CR31","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-020-75673-7","volume":"10","author":"AY Abuhelwa","year":"2020","unstructured":"Abuhelwa AY, Hopkins AM, Sorich MJ, Proudman S, Foster DJ, Wiese MD. Association between obesity and remission in rheumatoid arthritis patients treated with disease-modifying anti-rheumatic drugs. Sci Rep. 2020;10(1):1\u20139.","journal-title":"Sci Rep"},{"issue":"6","key":"2653_CR32","doi-asserted-by":"publisher","first-page":"270","DOI":"10.11622\/smedj.2019057","volume":"60","author":"YX Lee","year":"2019","unstructured":"Lee YX, Kwan YH, Lim KK, Tan CS, Lui NL, Phang JK, et al. A systematic review of the association of obesity with the outcomes of inflammatory rheumatic diseases. Singap Med J. 2019;60(6):270.","journal-title":"Singap Med J"},{"issue":"2","key":"2653_CR33","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1002\/acr.22932","volume":"69","author":"Y Liu","year":"2017","unstructured":"Liu Y, Hazlewood GS, Kaplan GG, Eksteen B, Barnabe C. Impact of obesity on remission and disease activity in rheumatoid arthritis: a systematic review and meta-analysis. Arthr Care Res. 2017;69(2):157\u201365.","journal-title":"Arthr Care Res"},{"issue":"1","key":"2653_CR34","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13075-016-1194-8","volume":"18","author":"R Lupoli","year":"2016","unstructured":"Lupoli R, Pizzicato P, Scalera A, Ambrosino P, Amato M, Peluso R, et al. Impact of body weight on the achievement of minimal disease activity in patients with rheumatic diseases: a systematic review and meta-analysis. Arthr Res Ther. 2016;18(1):1\u20139.","journal-title":"Arthr Res Ther"},{"issue":"2","key":"2653_CR35","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1016\/j.jbspin.2018.03.007","volume":"86","author":"J Shan","year":"2019","unstructured":"Shan J, Zhang J. Impact of obesity on the efficacy of different biologic agents in inflammatory diseases: a systematic review and meta-analysis. Joint Bone Spine. 2019;86(2):173\u201383.","journal-title":"Joint Bone Spine"},{"issue":"5","key":"2653_CR36","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0195123","volume":"13","author":"S Singh","year":"2018","unstructured":"Singh S, Facciorusso A, Singh AG, Casteele NV, Zarrinpar A, Prokop LJ, et al. Obesity and response to anti-tumor necrosis factor-\u03b1 agents in patients with select immune-mediated inflammatory diseases: a systematic review and meta-analysis. PLoS One. 2018;13(5):e0195123.","journal-title":"PLoS One"},{"issue":"12","key":"2653_CR37","doi-asserted-by":"publisher","first-page":"2261","DOI":"10.3899\/jrheum.150224","volume":"42","author":"C Vidal","year":"2015","unstructured":"Vidal C, Barnetche T, Morel J, Combe B, Da\u00efen C. Association of body mass index categories with disease activity and radiographic joint damage in rheumatoid arthritis: a systematic review and metaanalysis. J Rheumatol. 2015;42(12):2261\u20139.","journal-title":"J Rheumatol"},{"issue":"12","key":"2653_CR38","doi-asserted-by":"publisher","first-page":"2655","DOI":"10.1007\/s10067-017-3788-1","volume":"36","author":"M-A D\u2019Agostino","year":"2017","unstructured":"D\u2019Agostino M-A, Alten R, Mysler E, Le Bars M, Ye J, Murthy B, et al. Body mass index and clinical response to intravenous or subcutaneous abatacept in patients with rheumatoid arthritis. Clin Rheumatol. 2017;36(12):2655\u201365.","journal-title":"Clin Rheumatol"},{"issue":"10","key":"2653_CR39","doi-asserted-by":"publisher","first-page":"1743","DOI":"10.1136\/annrheumdis-2017-211569","volume":"76","author":"MD George","year":"2017","unstructured":"George MD, \u00d8stergaard M, Conaghan PG, Emery P, Baker DG, Baker JF. Obesity and rates of clinical remission and low MRI inflammation in rheumatoid arthritis. Ann Rheum Dis. 2017;76(10):1743\u20136.","journal-title":"Ann Rheum Dis"},{"issue":"2","key":"2653_CR40","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2017-000458","volume":"3","author":"A Levitsky","year":"2017","unstructured":"Levitsky A, Brismar K, Hafstrom I, Hambardzumyan K, Lourdudoss C, van Vollenhoven RF, et al. Obesity is a strong predictor of worse clinical outcomes and treatment responses in early rheumatoid arthritis: results from the SWEFOT trial. RMD Open. 2017;3(2):e000458.","journal-title":"RMD Open"},{"issue":"12","key":"2653_CR41","doi-asserted-by":"publisher","first-page":"1789","DOI":"10.1002\/acr.23229","volume":"69","author":"MD George","year":"2017","unstructured":"George MD, Giles JT, Katz PP, England BR, Mikuls TR, Michaud K, et al. Impact of obesity and adiposity on inflammatory markers in patients with rheumatoid arthritis. Arthr Care Res. 2017;69(12):1789\u201398.","journal-title":"Arthr Care Res"},{"issue":"9","key":"2653_CR42","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1038\/nrrheum.2016.121","volume":"12","author":"A Courties","year":"2016","unstructured":"Courties A, Sellam J. Disconnect in the effects of obesity on RA outcomes. Nat Rev Rheumatol. 2016;12(9):501\u20132.","journal-title":"Nat Rev Rheumatol"},{"issue":"12","key":"2653_CR43","doi-asserted-by":"publisher","first-page":"2136","DOI":"10.1093\/rheumatology\/ket169","volume":"52","author":"F Matcham","year":"2013","unstructured":"Matcham F, Rayner L, Steer S, Hotopf M. The prevalence of depression in rheumatoid arthritis: a systematic review and meta-analysis. Rheumatology (Oxford, England). 2013;52(12):2136\u201348.","journal-title":"Rheumatology (Oxford, England)"},{"issue":"3","key":"2653_CR44","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1016\/j.genhosppsych.2013.12.004","volume":"36","author":"L Rayner","year":"2014","unstructured":"Rayner L, Matcham F, Hutton J, Stringer C, Dobson J, Steer S, et al. Embedding integrated mental health assessment and management in general hospital settings: feasibility, acceptability and the prevalence of common mental disorder. Gen Hosp Psychiatry. 2014;36(3):318\u201324.","journal-title":"Gen Hosp Psychiatry"},{"issue":"10","key":"2653_CR45","doi-asserted-by":"publisher","first-page":"1785","DOI":"10.1093\/rheumatology\/kes356","volume":"52","author":"AM Rathbun","year":"2013","unstructured":"Rathbun AM, Reed GW, Harrold LR. The temporal relationship between depression and rheumatoid arthritis disease activity, treatment persistence and response: a systematic review. Rheumatology (Oxford, England). 2013;52(10):1785\u201394.","journal-title":"Rheumatology (Oxford, England)"},{"key":"2653_CR46","doi-asserted-by":"crossref","unstructured":"Gwinnutt JM, Norton S, Hyrich KL, Lunt M, Barton A, Cordingley L, et al. Changes in the illness perceptions of patients with rheumatoid arthritis over the first year of methotrexate therapy.\u00a0Rheumatology (Oxford).\u00a02021;60(5):2355\u201365.","DOI":"10.1093\/rheumatology\/keaa615"},{"issue":"1","key":"2653_CR47","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2019-001146","volume":"6","author":"K Van der Elst","year":"2020","unstructured":"Van der Elst K, Verschueren P, De Cock D, De Groef A, Stouten V, Pazmino S, et al. One in five patients with rapidly and persistently controlled early rheumatoid arthritis report poor well-being after 1 year of treatment. RMD Open. 2020;6(1):e001146.","journal-title":"RMD Open"}],"container-title":["Arthritis Research &amp; Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13075-021-02653-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13075-021-02653-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13075-021-02653-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,4]],"date-time":"2021-11-04T07:05:03Z","timestamp":1636009503000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthritis-research.biomedcentral.com\/articles\/10.1186\/s13075-021-02653-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,4]]},"references-count":47,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["2653"],"URL":"https:\/\/doi.org\/10.1186\/s13075-021-02653-1","relation":{},"ISSN":["1478-6362"],"issn-type":[{"value":"1478-6362","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,4]]},"assertion":[{"value":"29 March 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 October 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 November 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The TITRATE trial was ethically approved by the London \u2013 West London & GTAC National Research Ethics Service (NRES) Committee (13\/LO\/1308).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"EN has received speaker honoraria\/participated in advisory boards for Pfizer, AbbVie, Sanofi, Gilead, Celltrion and Lilly. The other authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"278"}}