Rheumatology 2000; 39: 835-843
© 2000 British Society for Rheumatology
Reviews |
Early inflammatory polyarthritis: results from the Norfolk Arthritis Register with a review of the literature. I. Risk factors for the development of inflammatory polyarthritis and rheumatoid arthritis
ARC Epidemiology Unit, University of Manchester Medical School, Oxford Road, Manchester and East Cheshire NHS Trust, Macclesfield and
1 Withington Hospital, Manchester, UK
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Introduction |
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Soon after people develop a chronic disease such as rheumatoid arthritis (RA), they ask their physicians two searching questions: the first is ‘Why me?’ and the second is ‘What will happen to me now?’ In 1989 the ARC Epidemiology Unit set up the Norfolk Arthritis Register (NOAR) with the aim of providing answers to these two questions. This paper is the first in a series of two reviews which focus on the work of NOAR, a register of a primary care-based inception cohort of patients with inflammatory polyarthritis (IP). The present paper examines genetic and environmental risk factors for the development of IP and of its subset, RA. The second paper summarizes the natural history and predictors of prognosis [87]. In both papers the NOAR data are presented in the context of a detailed review of the literature which summarizes current knowledge in this challenging area.
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Background |
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The cause
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The Norfolk Arthritis Register |
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Assessment of patients referred to NOAR |
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The NOAR case–control study |
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Genetic risk factors |
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Hormonal and reproductive risk factors |
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Environmental risk factors |
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Medical risk factors
‘Lifestyle’ risk factors
Psychological and physical trauma as risk factors
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Conclusion |
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