CALIBER Rheumatoid Arthritis phenotype

person Phenotype Rheumatoid Arthritis
person Type Disease or syndrome
person Data sources Primary care (CPRD), hospital admission data (HES)
person Clinical Terminologies Read, ICD-9, ICD-10
person Valid event date range 01/01/1999 - 01/07/2016
person Sex Female/Male
person Agreed 23.11.2012 (Revision 2)
person Authors Mar Pujades-Rodriguez , Bram Duyx, Sara L. Thomas, Dimitris Stogiannis, Anisur Rahman, Liam Smeeth, Harry Hemingway

Primary Care (incident and prevalent)

In the Clinical Practice Research Datalink (CPRD, primary care data) we ascertained cases by searching for Read terms related to:

RA diagnoses

Read codeRead termCALIBER category
2G27.00 O/E-hands-rheumatoid spindling Rheumatoid arthritis
66H..13 Rheumatoid arthrit. monitoring Rheumatoid arthritis
F371200 Polyneuropathy in rheumatoid arthritis Rheumatoid arthritis
F396400 Myopathy due to rheumatoid arthritis Rheumatoid arthritis
G5y8.00 Rheumatoid myocarditis Rheumatoid arthritis
G5yA.00 Rheumatoid carditis Rheumatoid arthritis
H570.00 Rheumatoid lung Rheumatoid arthritis
N005.00 Adult Still's Disease Rheumatoid arthritis
N040.00 Rheumatoid arthritis Rheumatoid arthritis
N040000 Rheumatoid arthritis of cervical spine Rheumatoid arthritis
N040100 Other rheumatoid arthritis of spine Rheumatoid arthritis
N040200 Rheumatoid arthritis of shoulder Rheumatoid arthritis
N040500 Rheumatoid arthritis of elbow Rheumatoid arthritis
N040600 Rheumatoid arthritis of distal radio-ulnar joint Rheumatoid arthritis
N040700 Rheumatoid arthritis of wrist Rheumatoid arthritis
N040800 Rheumatoid arthritis of MCP joint Rheumatoid arthritis
N040900 Rheumatoid arthritis of PIP joint of finger Rheumatoid arthritis
N040A00 Rheumatoid arthritis of DIP joint of finger Rheumatoid arthritis
N040B00 Rheumatoid arthritis of hip Rheumatoid arthritis
N040D00 Rheumatoid arthritis of knee Rheumatoid arthritis
N040F00 Rheumatoid arthritis of ankle Rheumatoid arthritis
N040G00 Rheumatoid arthritis of subtalar joint Rheumatoid arthritis
N040H00 Rheumatoid arthritis of talonavicular joint Rheumatoid arthritis
N040J00 Rheumatoid arthritis of other tarsal joint Rheumatoid arthritis
N040K00 Rheumatoid arthritis of 1st MTP joint Rheumatoid arthritis
N040N00 Rheumatoid vasculitis Rheumatoid arthritis
N040P00 Seronegative rheumatoid arthritis Rheumatoid arthritis
N040Q00 Rheumatoid bursitis Rheumatoid arthritis
N040R00 Rheumatoid nodule Rheumatoid arthritis
N040S00 Rheumatoid arthritis - multiple joint Rheumatoid arthritis
N040T00 Flare of rheumatoid arthritis Rheumatoid arthritis
N041.00 Felty's syndrome Rheumatoid arthritis
N042.00 Other rheumatoid arthropathy + visceral/systemic involvement Rheumatoid arthritis
N042100 Rheumatoid lung disease Rheumatoid arthritis
N042200 Rheumatoid nodule Rheumatoid arthritis
N042z00 Rheumatoid arthropathy + visceral/systemic involvement NOS Rheumatoid arthritis
N047.00 Seropositive errosive rheumatoid arthritis Rheumatoid arthritis
N04X.00 "Seropositive rheumatoid arthritis, unspecified" Rheumatoid arthritis
N04y000 Rheumatoid lung Rheumatoid arthritis
N04y011 Caplan's syndrome Rheumatoid arthritis
N04y012 Fibrosing alveolitis associated with rheumatoid arthritis Rheumatoid arthritis
N04y200 Adult-onset Still's disease Rheumatoid arthritis
Nyu1100 [X]Other seropositive rheumatoid arthritis Rheumatoid arthritis
Nyu1200 [X]Other specified rheumatoid arthritis Rheumatoid arthritis
Nyu1G00 [X]Seropositive rheumatoid arthritis, unspecified Rheumatoid arthritis
RA family history

Read codeRead termCALIBER category
14G1.00 H/O: rheumatoid arthritis History of rheumatoid arthritis
Juvenille RA

Read codeRead termCALIBER category
N043.00 Juvenile rheumatoid arthritis - Still's disease Juvenile rheumatoid arthritis
N043000 Juvenile rheumatoid arthropathy unspecified Juvenile rheumatoid arthritis
N043100 Acute polyarticular juvenile rheumatoid arthritis Juvenile rheumatoid arthritis
N043200 Pauciarticular juvenile rheumatoid arthritis Juvenile rheumatoid arthritis
N043300 Monarticular juvenile rheumatoid arthritis Juvenile rheumatoid arthritis
N043z00 Juvenile rheumatoid arthritis NOS Juvenile rheumatoid arthritis
N045500 Juvenile rheumatoid arthritis Juvenile rheumatoid arthritis
Referral to specialist care

Read codeRead termCALIBER category
8H4B.00 Referred to rheumatologist Referral to specialist
8HTd.00 Referral to rheumatology clinic Referral to specialist
8HVQ.00 Private referral to rheumatologist Referral to specialist
ZL5AR00 Referral to rheumatologist Referral to specialist
66H2.00 Rheumat. follow-up assessment Under care of specialist
9N1O.00 Seen in rheumatology clinic Under care of specialist
9NJr.00 In-house rheumatology follow-up appointment Under care of specialist
9NNT.00 Under care of rheumatologist Under care of specialist
ZL18T00 Under care of rheumatologist Under care of specialist
ZL9AT00 Seen by rheumatologist Under care of specialist
ZLD3T00 Discharge by rheumatologist Under care of specialist
Rheumatoid Factor
If result is higher than 25 iu/mL, then the result is positive. If the result is lower or equal to 25 iu/mL then the result is not positive.
Disease-modifying antirheumatic drugs (DMARD)

Product codeMedication
27342 MAXTREX injection 2.5mg/ml [PHARMACIA]
21753 MAXTREX tablets 10mg [PHARMACIA]
13428 MAXTREX tablets 2.5mg [PHARMACIA]
27579 METHOTREXATE
21889 METHOTREXATE 25MG/1ML
36167 methotrexate injection 1000mg/10ml
46407 methotrexate injection 1000mg/40ml
12816 methotrexate injection 100mg/ml
40371 methotrexate injection 10mg/0.2ml
7337 methotrexate injection 10mg/0.4ml
32865 methotrexate injection 10mg/1ml
46152 methotrexate injection 12.5mg/0.25ml
7336 methotrexate injection 12.5mg/0.5ml
40281 methotrexate injection 15mg/0.3ml
16540 methotrexate injection 15mg/0.6ml
27404 methotrexate injection 15mg/1.5ml
46156 methotrexate injection 17.5mg/0.35ml
18890 methotrexate injection 17.5mg/0.7ml
40273 methotrexate injection 20mg/0.4ml
14347 methotrexate injection 20mg/0.8ml
34258 METHOTREXATE injection 20mg/0.8ml [CENT HOME]
45165 methotrexate injection 20mg/1ml
26064 methotrexate injection 20mg/2ml
46129 methotrexate injection 22.5mg/0.45ml
17672 methotrexate injection 22.5mg/0.9ml
40328 methotrexate injection 25mg/0.5ml
45558 methotrexate injection 25mg/1.25ml
16519 methotrexate injection 25mg/1ml
24634 methotrexate injection 25mg/2.5ml
8583 methotrexate injection 25mg/ml
27642 methotrexate injection 27.5mg/1.1ml
44908 methotrexate injection 30mg/0.6ml
30703 methotrexate injection 30mg/1.2ml
46039 methotrexate injection 30mg/1.5ml
41086 methotrexate injection 5000mg/50ml
32229 methotrexate injection 500mg/20ml
24783 methotrexate injection 50mg/2ml
8327 methotrexate injection 50mg/3ml
30932 methotrexate injection 5mg/0.2ml
9528 methotrexate injection 5mg/2ml
40301 methotrexate injection 7.5mg/0.15ml
16570 methotrexate injection 7.5mg/0.3ml
35402 methotrexate injection 7.5mg/0.75ml
36800 methotrexate oral solution 10mg/5ml
36849 methotrexate oral suspension 10mg/5ml
28041 methotrexate oral suspension 12.5mg/5ml
35752 methotrexate oral suspension 7.5mg/5ml
14748 methotrexate sodium injection 25mg/ml
18424 methotrexate sodium tablets 2.5mg
41585 METHOTREXATE SODIUM tablets 2.5mg [WYETH PHAR]
29069 methotrexate sterile powder 500mg/vial
17035 methotrexate suspension 2.5mg/5ml
877 methotrexate tablets 10mg
34929 METHOTREXATE tablets 10mg [MAYNE]
823 methotrexate tablets 2.5mg
41104 METHOTREXATE tablets 2.5mg [CP PHARM]
20951 METHOTREXATE tablets 2.5mg [GOLDSHIELD]
32111 METHOTREXATE tablets 2.5mg [MAYNE]
30780 METHOTREXATE tablets 2.5mg [PHARMACIA]
40356 METOJECT injection 10mg/0.2ml [MEDAC UK]
37117 METOJECT injection 10mg/1ml [MEDAC UK]
46098 METOJECT injection 12.5mg/0.25ml [MEDAC UK]
40284 METOJECT injection 15mg/0.3ml [MEDAC UK]
27400 METOJECT injection 15mg/1.5ml [MEDAC UK]
46265 METOJECT injection 17.5mg/0.35ml [MEDAC UK]
40292 METOJECT injection 20mg/0.4ml [MEDAC UK]
14348 METOJECT injection 20mg/2ml [MEDAC UK]
46197 METOJECT injection 22.5mg/0.45ml [MEDAC UK]
40293 METOJECT injection 25mg/0.5ml [MEDAC UK]
33601 METOJECT injection 25mg/2.5ml [MEDAC UK]
40280 METOJECT injection 7.5mg/0.15ml [MEDAC UK]
35865 METOJECT injection 7.5mg/0.75ml [MEDAC UK]
Disease-modifying antirheumatic drugs (DMARD) monitoring

Read codeRead termCALIBER category
66c0.00 Disease modifying antirheumatic drug monitoring DMARD monitoring
9kN..00 DMARD monitoring - enhanced services administration DMARD monitoring
9kN4.11 Patient held DMARD therapy record checked DMARD monitoring
9kN6.00 DMARD monitored in primary care - enhanced services admin DMARD monitoring
9NiK.00 DNA hospital DMARD monitoring clinic DMARD monitoring
9NkF.00 Seen in GP DMARD monitoring clinic DMARD monitoring
9NkH.00 Seen in hospital DMARD monitoring clinic DMARD monitoring
9Oe..00 Community DMARD monitoring administration DMARD monitoring
9Oe0.00 Community DMARD monitoring appointment DMARD monitoring
9Oe1.00 Community DMARD monitoring suspended DMARD monitoring
9Oe2.00 Community DMARD monitoring not appropriate DMARD monitoring

Read terms are hierarhically organized in top-level chapters i.e. chapter G....00 is related to Circulatory System Diseases and sub-headings i.e. heading G2...00 is related to Hypertensive Heart Disease while G3...00 is related to Ischaemic Heart Disease.

Secondary Care (incident and prevalent)

In Hospital Episode Statistics (HES, hospital admission data) we used ICD-10 terms (see below) for diagnosis when marked as the primary diagnosis i.e. the main condition treated or investigated during the relevant episode of healthcare. We used the date of admission to hospital as the date of the event. We additionally searched for OPCS-4 terms indicating releted procedures.

RA diagnoses

ICD-10 codeICD-10 termCALIBER category
I528 Rheumatoid carditis Rheumatoid arthritis
J990 Rheumatoid lung disease Rheumatoid arthritis
M050 Felty's syndrome Rheumatoid arthritis
M051 Rheumatoid lung disease Rheumatoid arthritis
M052 Rheumatoid vasculitis Rheumatoid arthritis
M053 Rheumatoid arthritis with involvement of oth organs and sys Rheumatoid arthritis
M058 Other seropositive rheumatoid arthritis Rheumatoid arthritis
M059 Seropositive rheumatoid arthritis, unspecified Rheumatoid arthritis
M060 Seronegative rheumatoid arthritis Rheumatoid arthritis
M061 Adult-onset Still's disease Rheumatoid arthritis
M062 Rheumatoid bursitis Rheumatoid arthritis
M063 Rheumatoid nodule Rheumatoid arthritis
M068 Other specified rheumatoid arthritis Rheumatoid arthritis
M069 Rheumatoid arthritis, unspecified Rheumatoid arthritis
Juvenille RA

ICD-10 codeICD-10 termCALIBER category
M080 Juvenile rheumatoid arthritis Juvenile rheumatoid arthritis
M082 Juvenile arthritis with systemic onset Juvenile rheumatoid arthritis
M083 Juvenile polyarthritis (seronegative) Juvenile rheumatoid arthritis
M084 Pauciarticular juvenile arthritis Juvenile rheumatoid arthritis
Not applicable.

Combining evidence across sources to define and date phenotypes

CALIBER Atrial Fibrillation Phenotype flowchart
Flow chart diagram illustrating the CALIBER phenotype algorithm for atrial fibrillation
Risk factor Publication
Sex How Does Cardiovascular Disease First Present in Women and Men? Incidence of 12 Cardiovascular Diseases in a Contemporary Cohort of 1,937,360 People. Circulation. 2015 Oct 6;132(14):1320-8. doi: 10.1161/CIRCULATIONAHA.114.013797. Epub 2015 Sep 1.
Type 2 diabetes Type 2 diabetes and incidence of a wide range of cardiovascular diseases: a cohort study in 1.9 million people. Lancet. 2015 Feb 26;385 Suppl 1:S86. doi: 10.1016/S0140-6736(15)60401-9.
Smoking Heterogeneous associations between smoking and a wide range of initial presentations of cardiovascular disease in 1937360 people in England: lifetime risks and implications for risk prediction. Int J Epidemiol. 2015 Feb;44(1):129-41. doi: 10.1093/ije/dyu218. Epub 2014 Nov 20.
Socioeconomic status Socioeconomic deprivation and the incidence of 12 cardiovascular diseases in 1.9 million women and men: implications for risk prediction and prevention. PLoS One. 2014 Aug 21;9(8):e104671. doi: 10.1371/journal.pone.0104671. eCollection 2014.
Blood pressure Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1.25 million people. Lancet. 2014 May 31;383(9932):1899-911. doi: 10.1016/S0140-6736(14)60685-1.
Heart rate Archangelidi O et al. Clinically recorded heart rate and incidence of 12 coronary, cardiac, cerebrovascular and peripheral arterial diseases in 233,970 men and women: A linked electronic health record study. Eur J Prev Cardiol. 2018 Sep;25(14):1485-1495. doi: 10.1177/2047487318785228. Epub 2018 Jul 2.
Ethnicity George J et al. Ethnicity and the first diagnosis of a wide range of cardiovascular diseases: Associations in a linked electronic health record cohort of 1 million patients. PLoS One. 2017 Jun 9;12(6):e0178945. doi: 10.1371/journal.pone.0178945. eCollection 2017.
Alcohol Association between clinically recorded alcohol consumption and initial presentation of 12 cardiovascular diseases: population based cohort study using linked health records. BMJ. 2017 Mar 22;356:j909. doi: 10.1136/bmj.j909.
Giant cell arteritis Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases. Heart. 2016 Mar;102(5):383-9. doi: 10.1136/heartjnl-2015-308514. Epub 2016 Jan 19
Giant cell arteritis Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases. Heart. 2016 Mar;102(5):383-9. doi: 10.1136/heartjnl-2015-308514. Epub 2016 Jan 19
Neutrophils Neutrophil Counts and Initial Presentation of 12 Cardiovascular Diseases: A CALIBER Cohort Study. J Am Coll Cardiol. 2017 Mar 7;69(9):1160-1169. doi: 10.1016/j.jacc.2016.12.022.
Eosinophils Low eosinophil and low lymphocyte counts and the incidence of 12 cardiovascular diseases: a CALIBER cohort study. Open Heart. 2016 Sep 5;3(2):e000477. doi: 10.1136/openhrt-2016-000477. eCollection 2016.
Depression Depression as a Risk Factor for the Initial Presentation of Twelve Cardiac, Cerebrovascular, and Peripheral Arterial Diseases: Data Linkage Study of 1.9 Million Women and Men. PLoS One. 2016 Apr 22;11(4):e0153838. doi: 10.1371/journal.pone.0153838. eCollection 2016.
Polymyalgia rheumatica Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases. Heart. 2016 Mar;102(5):383-9. doi: 10.1136/heartjnl-2015-308514. Epub 2016 Jan 19
Lymphocytes Low eosinophil and low lymphocyte counts and the incidence of 12 cardiovascular diseases: a CALIBER cohort study. Open Heart. 2016 Sep 5;3(2):e000477. doi: 10.1136/openhrt-2016-000477. eCollection 2016.
Rheumatoid arthritis Rheumatoid Arthritis and Incidence of Twelve Initial Presentations of Cardiovascular Disease: A Population Record-Linkage Cohort Study in England. PLoS One. 2016 Mar 15;11(3):e0151245. doi: 10.1371/journal.pone.0151245.
Risk factor Publication
Sex How Does Cardiovascular Disease First Present in Women and Men? Incidence of 12 Cardiovascular Diseases in a Contemporary Cohort of 1,937,360 People. Circulation. 2015 Oct 6;132(14):1320-8. doi: 10.1161/CIRCULATIONAHA.114.013797. Epub 2015 Sep 1.
Type 2 diabetes Type 2 diabetes and incidence of a wide range of cardiovascular diseases: a cohort study in 1.9 million people. Lancet. 2015 Feb 26;385 Suppl 1:S86. doi: 10.1016/S0140-6736(15)60401-9.
Smoking Heterogeneous associations between smoking and a wide range of initial presentations of cardiovascular disease in 1937360 people in England: lifetime risks and implications for risk prediction. Int J Epidemiol. 2015 Feb;44(1):129-41. doi: 10.1093/ije/dyu218. Epub 2014 Nov 20.
Socioeconomic status Socioeconomic deprivation and the incidence of 12 cardiovascular diseases in 1.9 million women and men: implications for risk prediction and prevention. PLoS One. 2014 Aug 21;9(8):e104671. doi: 10.1371/journal.pone.0104671. eCollection 2014.
Blood pressure Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1.25 million people. Lancet. 2014 May 31;383(9932):1899-911. doi: 10.1016/S0140-6736(14)60685-1.
Heart rate Archangelidi O et al. Clinically recorded heart rate and incidence of 12 coronary, cardiac, cerebrovascular and peripheral arterial diseases in 233,970 men and women: A linked electronic health record study. Eur J Prev Cardiol. 2018 Sep;25(14):1485-1495. doi: 10.1177/2047487318785228. Epub 2018 Jul 2.
Ethnicity George J et al. Ethnicity and the first diagnosis of a wide range of cardiovascular diseases: Associations in a linked electronic health record cohort of 1 million patients. PLoS One. 2017 Jun 9;12(6):e0178945. doi: 10.1371/journal.pone.0178945. eCollection 2017.
Alcohol Association between clinically recorded alcohol consumption and initial presentation of 12 cardiovascular diseases: population based cohort study using linked health records. BMJ. 2017 Mar 22;356:j909. doi: 10.1136/bmj.j909.
Giant cell arteritis Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases. Heart. 2016 Mar;102(5):383-9. doi: 10.1136/heartjnl-2015-308514. Epub 2016 Jan 19
Giant cell arteritis Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases. Heart. 2016 Mar;102(5):383-9. doi: 10.1136/heartjnl-2015-308514. Epub 2016 Jan 19
Neutrophils Neutrophil Counts and Initial Presentation of 12 Cardiovascular Diseases: A CALIBER Cohort Study. J Am Coll Cardiol. 2017 Mar 7;69(9):1160-1169. doi: 10.1016/j.jacc.2016.12.022.
Eosinophils Low eosinophil and low lymphocyte counts and the incidence of 12 cardiovascular diseases: a CALIBER cohort study. Open Heart. 2016 Sep 5;3(2):e000477. doi: 10.1136/openhrt-2016-000477. eCollection 2016.
Depression Depression as a Risk Factor for the Initial Presentation of Twelve Cardiac, Cerebrovascular, and Peripheral Arterial Diseases: Data Linkage Study of 1.9 Million Women and Men. PLoS One. 2016 Apr 22;11(4):e0153838. doi: 10.1371/journal.pone.0153838. eCollection 2016.
Polymyalgia rheumatica Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases. Heart. 2016 Mar;102(5):383-9. doi: 10.1136/heartjnl-2015-308514. Epub 2016 Jan 19
Lymphocytes Low eosinophil and low lymphocyte counts and the incidence of 12 cardiovascular diseases: a CALIBER cohort study. Open Heart. 2016 Sep 5;3(2):e000477. doi: 10.1136/openhrt-2016-000477. eCollection 2016.
Rheumatoid arthritis Rheumatoid Arthritis and Incidence of Twelve Initial Presentations of Cardiovascular Disease: A Population Record-Linkage Cohort Study in England. PLoS One. 2016 Mar 15;11(3):e0151245. doi: 10.1371/journal.pone.0151245.
Pujades-Rodriguez, Mar, Bram Duyx, Sara L. Thomas, Dimitris Stogiannis, Anisur Rahman, Liam Smeeth, and Harry Hemingway. "Rheumatoid arthritis and incidence of twelve initial presentations of cardiovascular disease: a population record-linkage cohort study in England." PLoS One 11, no. 3 (2016): e0151245.