The Gestalt of Early Arthritis in Europe: Beyond expert opinion alone


The clinical presentation of early arthritis (EA) is variable and patients may evolve differently over time. Some will develop RA or PsA, while others may remain with mild symptoms or even become symptom free. Management of EA has been the main focus of rheumatology research. The treatment model ‘the-earlier-the-better’ has dramatically benefited patients mostly by reducing disease burden and avoiding joint damage. However, this model may have led to ‘overdiagnosis’ and ‘overtreatment’. 
The project team proposes to evaluate EA using an approach that excludes the, likely biased, rheumatologist’s opinion, by analyzing data from three independet EA cohorts and applying analytical techniques. As a result different latent forms o EA and their evolvement over time shall be presented.

Facts and figures

Project lead
R Landewé
University of Amsterdam
FOREUM research grant: €226'186
2019 - 2022

Meet the team

R Landewé
University of Amsterdam
D van Schaardenburg
University of Amsterdan
A van der Helm-van Mil
UMC Leiden
S Ramiro
Leiden University
SA Bergstra
Leiden University
B Combe
University of Montpellier
A Sepriano
Nova Medical School
M de Wit
E Frazão Mateus
A Kent


To identify the forms (phenotypes) of EA, and how these change over time, by using analytical techniques that are independent of expert opinion. In detail:

• To identify the latent EA phenotypes by using an analytical technique that circumvents expert opinion.
• To assess if (and how) EA patients change latent phenotypes over time.
• To assess if there are prognostic dissimilarities between different latent EA phenotypes.
• To assess how the 2010 EULAR-ACR RA classification criteria capture the latent EA phenotypes.

Patient voice

The project team will be assisted by the constant input and support of a patients’ advisory group (PAG) consisting of three experienced PRPs. The PAG will be involved in all steps, including study concept, data interpretation and participation in meetings. The principal investigator and the study coordinator will make the bridge between PRPs and other collaborators, by providing relevant information in lay language upfront of meetings and by clarifying expected roles and doubts whenever necessary. PRP contribution will be recognized by authorship in publications. Finally, the PAG will contribute to the design and development of the smartphone application, including liaising with national focus-groups to test usability from the patients's perspective.