Rapid radiological progression in the first year of early rheumatoid arthritis is predictive of disability and joint damage progression during 8 years of follow-up.

Abstract:

OBJECTIVE:Several prediction models for rapid radiological progression (RRP) in the first year of rheumatoid arthritis have been designed to aid rheumatologists in their choice of initial treatment. The association was assessed between RRP and disability and joint damage progression in 8 years. METHODS:Patients from the BeSt cohort were used. RRP was defined as an increase of ≥5 points in the Sharp/van der Heijde score (SHS) in year 1. Functional ability over 8 years, measured with the health assessment questionnaire (HAQ), was compared for patients with and without RRP using linear mixed models. Joint damage progression from years 1 to 8 was compared using logistic regression analyses. RESULTS:RRP was observed in 102/465 patients. Over 8 years, patients with RRP had worse functional ability: difference in HAQ score 0.21 (0.14 after adjustment for disease activity score (over time)). RRP was associated with joint damage progression ≥25 points in SHS in years 1-8: OR 4.6. CONCLUSION:RRP in year 1 is a predictor of worse functional ability over 8 years, independent of baseline joint damage and disease activity. Patients with RRP have more joint damage progression in subsequent years. RRP is thus a relevant outcome on which to base the initial treatment decision.

journal_name

Ann Rheum Dis

authors

van den Broek M,Dirven L,de Vries-Bouwstra JK,Dehpoor AJ,Goekoop-Ruiterman YP,Gerards AH,Kerstens PJ,Huizinga TW,Lems W,Allaart CF

doi

10.1136/annrheumdis-2011-201212

subject

Has Abstract

pub_date

2012-09-01 00:00:00

pages

1530-3

issue

9

eissn

0003-4967

issn

1468-2060

pii

annrheumdis-2011-201212

journal_volume

71

pub_type

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