RESEARCH - Prognostic laboratory markers of joint damage in RA

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Ann Rheum Dis. 2004 Sep 30 [Epub ahead of print]

Prognostic laboratory markers of joint damage in rheumatoid arthritis.

Lindqvist E, Eberhardt K, Bendtzen K, Heinegard D, Saxne T.

Lund University Hospital, Sweden.

OBJECTIVE: To investigate if determination of a set of laboratory

markers at baseline provides prognostic information regarding joint

damage in hands and feet in rheumatoid arthritis (RA). MATERIALS AND

METHODS: 183 patients with early RA included in a prospective study

1985-1989 were examined. Radiographic changes in hands and feet 5 and 10

years after inclusion were evaluated according to Larsen. The markers

analysed were: erythrocyte sedimentation rate (ESR) according to

Westergren, HLA- DRB alleles typed by restriction fragment length

polymorphism and C-reactive protein (CRP), Cartilage Oligomeric Matrix

Protein (COMP), Rheumatoid Factor (RF) of IgG, IgA and IgM type,

antibodies against cyclic citrullinated-peptide (anti-CCP) and

interleukin-1 & [alpha] (anti-IL-1alpha) analysed by immunoassays.

Multiple linear regression with backward elimination was used to

evaluate the prognostic value of the variables. RESULTS: The number of

positive patients was for IgG RF 117/176, IgA RF 138/176, IgM RF

139/176, anti- CCP 140/176 and for anti-IL-1alpha 40/182. ESR, presence

of IgA RF, serum levels of COMP and presence of anti-CCP were

significantly associated with more severe joint damage and presence of

anti-IL-1alpha with less severe joint damage, after 5 years. Baseline

CRP and anti-CCP predicted radiographic outcome after 10 years. A

stronger prediction was obtained by combining the prognostic factors.

CONCLUSIONS: Early determination of anti-CCP, IgA RF, anti-IL-1alpha,

ESR, CRP and COMP predicted development of joint damage in hands and

feet in this cohort. The combination of these measures reflecting

different aspects of the disease process should be useful for evaluation

of prognosis in individual patients with early RA.

PMID: 15458956

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

5458956 & dopt=Abstract

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