Objective We aimed to understand the association of nonarticular pain (NAP), regional and widespread, with patient‐reported outcomes in early rheumatoid arthritis (RA). Methods This real‐world, multicenter study observed participants with newly diagnosed active early RA (symptoms <1 year; Clinical Disease Activity Index [CDAI] score >2.8) over the first year. Participants were examined by rheumatologists and synchronously completed body pain diagrams and Patient‐Reported Outcomes Measurement Information System 29 (PROMIS‐29) measures at regular intervals. Participants were classified as follows: (1) no NAP, (2) regional NAP, or (3) widespread NAP. Associations between repeated measures of NAP and PROMIS‐29 over the first year were estimated in separate mixed models, adjusting for sociodemographic and RA characteristics and time‐varying CDAI. Results These 472 participants with early RA were mostly women (66%), had a mean age of 57 (SD 14) years, and had active disease (mean CDAI 27.0 [SD 14.1]). Over one‐half (n = 246, 52%) reported NAP at baseline; of these, 72% (176 of 246) had regional NAP, and 28% (70 of 246) had widespread NAP. Adjusted mean change in PROMIS‐29 domains were significantly worse in patients with regional versus no NAP: physical function ‐1.4 (95% confidence interval [CI] ‐2.1 to ‐0.7), pain interference 2.7 (95% CI 1.9–3.5), sleep disturbance 1.2 (95% CI 0.4–2.0), fatigue 2.1 (95% CI 1.2–3.1), anxiety 1.5 (95% CI 0.7–2.4), depression 1.4 (95% CI 0.5–2.2), and social participation ‐2.4 (95% CI ‐3.3 to ‐1.5). Associations between widespread and no NAP were larger for pain interference (5.0 [95% CI 3.7–6.4]), fatigue (3.2 [95% CI 1.7–4.8]), and social participation (‐5.6 [95% CI ‐7.2 to ‐4.0]). Mean physical function, pain interference, and social participation scores were well outside the normal range. Conclusion NAP interferes with key aspects of well‐being in early RA. Individuals with NAP experience greater pain interference and impairments in physical and social function, supporting a need for earlier identification of and interventions targeting NAP.

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