Symptoms in first degree relatives of patients with rheumatoid arthritis: evaluation of cross-sectional data from the symptoms in persons at risk of rheumatoid arthritis (SPARRA) questionnaire in the PRe-clinical EValuation of Novel Targets in RA (PREVeNT-RA) Cohort

Research output: Contribution to journalArticlepeer-review


  • Ruth Costello
  • Jennifer Humphreys
  • Jamie C. Sergeant
  • Mohammad Haris
  • Fiona Stirling
  • Dirkjan van Schaardenburg
  • Ian N Bruce

Colleges, School and Institutes

External organisations

  • University of Manchester
  • Central Manchester University Hospital NHS Foundation Trust and Manchester Academic Health Science Centre
  • Christie Hospital NHS Foundation Trust
  • Manchester University Hospitals NHS Foundation Trust
  • Reade and Amsterdam University Medical Center
  • Sandwell and West Birmingham Hospitals NHS Trust


Background: First degree relatives (FDRs) of people with rheumatoid arthritis (RA) have a four-fold increased risk of developing RA. The Symptoms in Persons At Risk of Rheumatoid Arthritis (SPARRA) questionnaire was developed to document symptoms in persons at risk of RA. The aims of this study were: 1) to describe symptoms in a cohort of FDRs of patients with RA overall and stratified by seropositivity and elevated CRP and 2) to determine if patient characteristics were associated with symptoms suggestive of RA.

Methods: A cross-sectional study of FDRs of patients with RA, in the PREVeNT-RA study, who completed a study questionnaire, provided a blood sample measured for rheumatoid factor, anti-CCP and CRP and completed the SPARRA questionnaire. Moderate/severe symptoms and symmetrical, small and large joint pain were identified and described. Symptoms associated with both seropositivity and elevated CRP were considered suggestive of RA. Logistic regression was used to determine if symptoms suggestive of RA were associated with patient characteristics.

Results: 870 participants provided all data, 43(5%) were seropositive and 122(14%) had elevated CRP. The most frequently reported symptoms were sleep disturbances (20.3%) and joint pain (17.9%). Symmetrical and small joint pain were 11.3% and 12.8% higher, respectively, in those who were seropositive and 11.5% and 10.7% higher in those with elevated CRP. In the logistic regression model, seropositivity, older age and feeling depressed were associated with increased odds of small and symmetrical joint pain.

Conclusions: This is the first time the SPARRA questionnaire has been applied in FDRs of patients with RA and has demonstrated that the presence of symmetrical and small joint pain in this group may be useful in identifying people at higher risk of developing RA.


Original languageEnglish
Article number210
Number of pages11
JournalArthritis Research & Therapy
Issue number1
Early online date11 Aug 2021
Publication statusE-pub ahead of print - 11 Aug 2021


  • Rheumatoid arthritis, Pre-RA, Arthralgia, Prevention, Epidemiology, Autoantibodies, Risk factors