Raynaud's phenomenon secondary to rheumatoid arthritis may be predictive of more erosive disease

[Guest guest]

Raynaud's phenomenon secondary to rheumatoid arthritis may be predictive of

more erosive disease

JE Pope and J Al-beshri

University of Western Ontario, London, Ontario, Canada

from Global Arthritis Research Network (GARN): 4th World Congress on

Arthritis in Montreal

Montreal, Quebec, Canada, 20­22 September 2004

Arthritis Res Ther 2004, 6(Suppl 3):75 doi:10.1186/ar1411

Published 13 September 2004

Purpose

Raynaud's phenomenon (RP) occurs less frequently in rheumatoid arthritis

(RA) than with other connective tissue diseases, such as scleroderma and

systemic lupus erythematosus. We studied the relationship between RP and

other disease characteristics common to RA to determine whether RP can be

predictive of more severe disease. Secondary analyses were preformed to

assess correlations between other antibodies/manifestations that occur in

RA, and the onset of RP versus RA disease duration.

Methods

Using a standardized assessment, data were collected on a cross-sectional

cohort of RA subjects (n = 329; mean age 60.3 ± 0.7 years; 77% female; 76%

erosions, 75% positive rheumatoid factor [RF]) who met the American College

of Rheumatology criteria for RA and had been seen at a London, Ontario

rheumatology clinical practice during the 6-month study period. Study

participants were prevalent (follow-up) cases and new referrals. A

subsequent chart review was performed to verify clinic data and also to

collect data on all variables that were not available at the time of the

clinic visit. RP was defined as pallor of the fingers along with rubor,

cyanosis, or both.

Outline Results

Top

Purpose

Methods

Results

Conclusion

The mean disease duration was 12 ± 0.6 years. Seventy patients (22%) had RP.

RP status was not related to gender, age, or disease duration. The mean age

at onset of RP was 50.7 ± 2 years and the mean RP duration was 9.2 ± 1.5

years. Patients presented with RP a mean of 3.8 ± 1.4 years after the

diagnosis of RA (95% confidence interval, 0.9­6.6 years; minimum, maximum =

31 years before RA diagnosis, 32 years after). RP status was not associated

with the presence of nodules and erosions. Patients with sclerodactyly [all

was distal to proximal interphalangeal joints] were more likely than those

without to have RP (34% versus 17%, P < 0.001). Subjects with sclerodactyly

(26%) were also more likely than those without to have erosions (86% versus

72%, P < 0.02). Patients who developed RP after their RA diagnosis were more

likely to have erosions than those who developed RP before RA (P < 0.005).

As expected, positive RF was associated with longer disease duration (P <

0.04). Higher RF values were associated with longer disease duration (P <

0.005) and increased RP duration (P < 0.01).

Conclusion

RP was present in 22% of the RA patients seen in a rheumatology clinical

practice in London, Ontario during the 6-month study period. RP appears to

develop relatively soon (approximately 1­7 years) after RA diagnosis in the

majority of cases. Idiopathic RP may be different from RP secondary to RA,

the latter of which may be associated with more erosive RA. Sclerodactyly is

associated with erosive arthritis and RP in RA. Higher RF values were

indicative of increased RA and RP duration.

http://arthritis-research.com/content/6/S3/75