Not treated over follow-up Treated over follow-up Time to ﬁrst treatment <6 Months 6–12 Months >12 Months Time receiving ﬁrst treatment ≤6 Months >6 to ≤36 Months >36 Months ≤48 Months >48 to ≤96 Months >96 Months Time receiving any treatment over 10 years n (%) 297 (46) 345 (54) 122 (35) 76 (22) 147 (43) 91 (26) 123 (36) 131 (38) 88 (26) 57 (17) 200 (58) Treated over follow-up Time to ﬁrst treatment <6 Months 6–12 Months >12 Months Effect of ﬁrst treatment duration ≤6 Months >6–≤36 Months >36 Months ≤48 Months >48–≤96 Months >96 Months Effect of treatment duration over 10 years Effect per number of months of ﬁrst treatment No of months treated in ﬁrst 6 months since symptom onset No of months treated after ﬁrst 6 months since symptom onset Effect per number of months of treatment over 10 years No of months treated in ﬁrst 6 months since symptom onset No of months treated after ﬁrst 6 months since symptom onset n 345 122 76 147 91 123 131 88 57 200 — — — — Table 5 Mean difference in change in Health Assessment Questionnaire (HAQ) over 10 years by time to, and time receiving, treatment—adjusted by baseline HAQ and marginal structural weight Difference in change in HAQ between baseline and year 10, compared with never treated Adjusted by baseline HAQ Adjusted by marginal structural weight Extended report Table 4 Health Assessment Questionnaire (HAQ) at baseline, 10 years and difference over 10 years, by time to, and time receiving, treatment improvement (adj_MDIC –0.37, 95% CI –0.77 to 0.04), although this was not signiﬁcant. Of the 642 subjects who had completed a HAQ both at base- line and at the 10 year assessment, 497 (77.4%) satisﬁed the ACR criteria for RA cumulatively over the 10 years of follow-up. Of these subjects, 316 (64%) had been treated by 10 years, of whom 110 (35%) were treated within 6 months of symptom onset. The results in table 5 were very similar when conﬁned to those who satisﬁed the ACR criteria for RA cumulatively over the 10 years of follow-up (data not shown). The impact of early treatment on long-term functional dis- ability is further highlighted by the signiﬁcant beneﬁt from each additional month of early treatment, be that the ﬁrst DMARD/S (adj_MDIC –0.09, 95% CI –0.17 to –0.01) or any subsequent Ann Rheum Dis 2010;69:689–695. doi:10.1136/ard.2009.108639 693 Baseline HAQ Median (IQR) 0.50 (0.13–0.88) 1.00 (0.50–1.50) 1.25 (0.63–1.75) 1.00 (0.44–1.63) 0.75 (0.38–1.38) 1.00 (0.38–1.50) 1.00 (0.38–1.63) 0.88 (0.50–1.50) 0.88 (0.25–1.50) 0.88 (0.38–1.63) 1.00 (0.50–1.56) Mean 0.30 0.13 0.35 0.39 0.41 –0.10 –0.10 0.08 0.35 –0.07 –0.09 –0.002 –0.10 0.003 10 Year HAQ Median (IQR) 0.50 (0.13–1.25) 1.38 (0.50–2.00) 1.25 (0.25–2.13) 1.50 (0.50–2.00) 1.38 (0.63–2.00) 1.63 (0.50–2.13) 1.38 (0.63–2.00) 1.25 (0.25–1.88) 0.88 (0.06–1.63) 1.50 (0.63–2.00) 1.50 (0.63–2.13) (95% CI) (0.18 to 0.42) (–0.04 to 0.3) (0.15 to 0.54) (0.24 to 0.54) (0.23 to 0.59) (–0.31 to 0.1) (–0.28 to 0.09) (–0.1 to 0.26) (0.1 to 0.6) (–0.29 to 0.15) (–0.15 to –0.03) (–0.004 to 0.0001) (–0.16 to –0.04) (0.001 to 0.005) Mean –0.01 –0.24 0.12 0.18 0.28 –0.25 –0.37 –0.21 0.53 –0.37 –0.09 –0.004 –0.10 0.001 Change over 10 years Mean (95% CI) 0.13 (0.05 to 0.21) 0.24 (0.14 to 0.33) 0.00 (–0.17 to 0.17) 0.28 (0.08 to 0.48) 0.41 (0.28 to 0.54) 0.35 (0.15 to 0.55) 0.24 (0.10 to 0.38) 0.16 (0.002 to 0.32) 0.06 (–0.12 to 0.25) 0.38 (0.13 to 0.63) 0.27 (0.15 to 0.39) (95% CI) (–0.20 to 0.19) (–0.58 to 0.09) (–0.13 to 0.37) (–0.06 to 0.41) (0.04 to 0.52) (–0.56 to 0.06) (–0.77 to 0.04) (–0.62 to 0.21) (–0.01 to 1.06) (–0.77 to 0.04) (–0.17 to –0.01) (–0.01 to –0.0004) (–0.19 to –0.02) (–0.002 to 0.005)