RESEARCH - Arthritis of the large joints, in particular the knee, at first presentation predictive of destruction in RA

[Guest guest]

Ann Rheum Dis. 2006 Dec 1; [Epub ahead of print]

Arthritis of the large joints, in particular the knee, at first presentation

is predictive for a high level of radiological destruction of the small

joints in rheumatoid arthritis.

Linn-Rasker SP, Van der Helm-van Mil AH, Breedveld FC, Huizinga TW.

Leiden University Medical Center, Netherlands.

OBJECTIVE: To investigate the predictive value of the distribution of

inflamed joints at first presentation for the severity of the disease course

in RA. METHODS: From 1009 consecutive patients included in the Leiden Early

Arthritis Clinic, 285 patients fulfilled the ACR-criteria for RA within

1-year of follow-up. Of these, 28 patients achieved remission. Radiographs

of hands and feet were scored according to the Sharp-van der Heijde method

and the 28 patients with the most destructive disease were selected. The

distribution of inflamed joints of the patients with the extreme disease

courses was compared. The association between the distribution of inflamed

joints and the level of destruction of the joints of hands and feet in the

whole group of RA-patients was assessed using regression analysis. RESULTS:

Comparison of the patients with extreme disease courses using univariate and

logistic regression analyses revealed that arthritis of the large joints, in

particular the knee, was associated with severe RA. In the whole group of

RA-patients, the total number of swollen joints and the presence of knee

arthritis associated independently with the level of destruction of the

small joints. RA-patients with knee arthritis had higher C-reactive protein

levels than patients without knee arthritis and investigating the

distribution of inflamed joints together with other variables yielded the

number of swollen joints, C-reactive protein level, presence of anti-CCP

antibodies and symptom duration as predictors for RA severity.

CONCLUSION: Arthritis of large joints, in particular the knee, at first

presentation is associated with a destructive course of RA.

PMID: 17142384

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

7142384

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

[Guest guest]

Great. I usually like your post, .<g>

I am Anti-CCP positive, which I'd already been told seems to be a

predictor of more severe RA. I also started this whole journey with

inflamation in my hips and shoulders, followed soon by knees and

wrists. I don't like the sound of this new study. :-?

>

> Ann Rheum Dis. 2006 Dec 1; [Epub ahead of print]

>

>

> Arthritis of the large joints, in particular the knee, at first

presentation

> is predictive for a high level of radiological destruction of the

small

> joints in rheumatoid arthritis.

>

>

> Linn-Rasker SP, Van der Helm-van Mil AH, Breedveld FC, Huizinga TW.

>

> Leiden University Medical Center, Netherlands.

>

> OBJECTIVE: To investigate the predictive value of the distribution

of

> inflamed joints at first presentation for the severity of the

disease course

> in RA. METHODS: From 1009 consecutive patients included in the

Leiden Early

> Arthritis Clinic, 285 patients fulfilled the ACR-criteria for RA

within

> 1-year of follow-up. Of these, 28 patients achieved remission.

Radiographs

> of hands and feet were scored according to the Sharp-van der

Heijde method

> and the 28 patients with the most destructive disease were

selected. The

> distribution of inflamed joints of the patients with the extreme

disease

> courses was compared. The association between the distribution of

inflamed

> joints and the level of destruction of the joints of hands and

feet in the

> whole group of RA-patients was assessed using regression analysis.

RESULTS:

> Comparison of the patients with extreme disease courses using

univariate and

> logistic regression analyses revealed that arthritis of the large

joints, in

> particular the knee, was associated with severe RA. In the whole

group of

> RA-patients, the total number of swollen joints and the presence

of knee

> arthritis associated independently with the level of destruction

of the

> small joints. RA-patients with knee arthritis had higher C-

reactive protein

> levels than patients without knee arthritis and investigating the

> distribution of inflamed joints together with other variables

yielded the

> number of swollen joints, C-reactive protein level, presence of

anti-CCP

> antibodies and symptom duration as predictors for RA severity.

>

> CONCLUSION: Arthritis of large joints, in particular the knee, at

first

> presentation is associated with a destructive course of RA.

>

> PMID: 17142384

>

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=PubMed & list_uids=17142384

>

>

>

>

> Not an MD

>

> I'll tell you where to go!

>

> Mayo Clinic in Rochester

> http://www.mayoclinic.org/rochester

>

> s Hopkins Medicine

> http://www.hopkinsmedicine.org

>

[Guest guest]

, I had early knee involvement, too, but I'm doing very well on

Enbrel. I feel so lucky that my rheumy found the right med for me. I

have almost no pain and inflammation. So I don't worry about these

predictors; they aren't necessarily going to apply to you.

Sue

On Tuesday, December 12, 2006, at 07:30 PM, Randall wrote:

> Great. I usually like your post, .<g>

>

> I am Anti-CCP positive, which I'd already been told seems to be a

> predictor of more severe RA. I also started this whole journey with

> inflamation in my hips and shoulders, followed soon by knees and

> wrists. I don't like the sound of this new study. :-?

[Guest guest]

So sorry, . Try to keep in mind that there are always exceptions.

Don't shoot the messenger??? Please???

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

[ ] Re: RESEARCH - Arthritis of the large joints, in

particular the knee, at first presentation predictive of destruction in RA

> Great. I usually like your post, .<g>

>

> I am Anti-CCP positive, which I'd already been told seems to be a

> predictor of more severe RA. I also started this whole journey with

> inflamation in my hips and shoulders, followed soon by knees and

> wrists. I don't like the sound of this new study. :-?

>

>

>

>

>>

>> Ann Rheum Dis. 2006 Dec 1; [Epub ahead of print]

>>

>>

>> Arthritis of the large joints, in particular the knee, at first

> presentation

>> is predictive for a high level of radiological destruction of the

> small

>> joints in rheumatoid arthritis.

>>

>>

>> Linn-Rasker SP, Van der Helm-van Mil AH, Breedveld FC, Huizinga TW.

>>

>> Leiden University Medical Center, Netherlands.

>>

>> OBJECTIVE: To investigate the predictive value of the distribution

> of

>> inflamed joints at first presentation for the severity of the

> disease course

>> in RA. METHODS: From 1009 consecutive patients included in the

> Leiden Early

>> Arthritis Clinic, 285 patients fulfilled the ACR-criteria for RA

> within

>> 1-year of follow-up. Of these, 28 patients achieved remission.

> Radiographs

>> of hands and feet were scored according to the Sharp-van der

> Heijde method

>> and the 28 patients with the most destructive disease were

> selected. The

>> distribution of inflamed joints of the patients with the extreme

> disease

>> courses was compared. The association between the distribution of

> inflamed

>> joints and the level of destruction of the joints of hands and

> feet in the

>> whole group of RA-patients was assessed using regression analysis.

> RESULTS:

>> Comparison of the patients with extreme disease courses using

> univariate and

>> logistic regression analyses revealed that arthritis of the large

> joints, in

>> particular the knee, was associated with severe RA. In the whole

> group of

>> RA-patients, the total number of swollen joints and the presence

> of knee

>> arthritis associated independently with the level of destruction

> of the

>> small joints. RA-patients with knee arthritis had higher C-

> reactive protein

>> levels than patients without knee arthritis and investigating the

>> distribution of inflamed joints together with other variables

> yielded the

>> number of swollen joints, C-reactive protein level, presence of

> anti-CCP

>> antibodies and symptom duration as predictors for RA severity.

>>

>> CONCLUSION: Arthritis of large joints, in particular the knee, at

> first

>> presentation is associated with a destructive course of RA.

>>

>> PMID: 17142384

>>

>> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

> cmd=Retrieve & db=PubMed & list_uids=17142384

[Guest guest]

,

I'm in the same club as you: high anti CCP and my RA started in my knees. It

helps me to keep in mind that we don't have any long term data on people like us

who are dx and treated with newer generation drugs. There's every reason to

think that the years ahead will bring even better treatments and even a cure.

After all, if researchers can figure out how the immune system settles down

during pregnancy, giving many women with RA a remission, maybe that can be

generalized to treating men and women with RA. We've come a long way from

NSAIDS and the years to come will surely bring more good news. Hang in there,

Kate F

<Matsumura_Clan@...> wrote:

So sorry, . Try to keep in mind that there are always exceptions.

Don't shoot the messenger??? Please???

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

[ ] Re: RESEARCH - Arthritis of the large joints, in

particular the knee, at first presentation predictive of destruction in RA

> Great. I usually like your post, .<g>

>

> I am Anti-CCP positive, which I'd already been told seems to be a

> predictor of more severe RA. I also started this whole journey with

> inflamation in my hips and shoulders, followed soon by knees and

> wrists. I don't like the sound of this new study. :-?

>

>

>

>

>>

>> Ann Rheum Dis. 2006 Dec 1; [Epub ahead of print]

>>

>>

>> Arthritis of the large joints, in particular the knee, at first

> presentation

>> is predictive for a high level of radiological destruction of the

> small

>> joints in rheumatoid arthritis.

>>

>>

>> Linn-Rasker SP, Van der Helm-van Mil AH, Breedveld FC, Huizinga TW.

>>

>> Leiden University Medical Center, Netherlands.

>>

>> OBJECTIVE: To investigate the predictive value of the distribution

> of

>> inflamed joints at first presentation for the severity of the

> disease course

>> in RA. METHODS: From 1009 consecutive patients included in the

> Leiden Early

>> Arthritis Clinic, 285 patients fulfilled the ACR-criteria for RA

> within

>> 1-year of follow-up. Of these, 28 patients achieved remission.

> Radiographs

>> of hands and feet were scored according to the Sharp-van der

> Heijde method

>> and the 28 patients with the most destructive disease were

> selected. The

>> distribution of inflamed joints of the patients with the extreme

> disease

>> courses was compared. The association between the distribution of

> inflamed

>> joints and the level of destruction of the joints of hands and

> feet in the

>> whole group of RA-patients was assessed using regression analysis.

> RESULTS:

>> Comparison of the patients with extreme disease courses using

> univariate and

>> logistic regression analyses revealed that arthritis of the large

> joints, in

>> particular the knee, was associated with severe RA. In the whole

> group of

>> RA-patients, the total number of swollen joints and the presence

> of knee

>> arthritis associated independently with the level of destruction

> of the

>> small joints. RA-patients with knee arthritis had higher C-

> reactive protein

>> levels than patients without knee arthritis and investigating the

>> distribution of inflamed joints together with other variables

> yielded the

>> number of swollen joints, C-reactive protein level, presence of

> anti-CCP

>> antibodies and symptom duration as predictors for RA severity.

>>

>> CONCLUSION: Arthritis of large joints, in particular the knee, at

> first

>> presentation is associated with a destructive course of RA.

>>

>> PMID: 17142384

>>

>> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

> cmd=Retrieve & db=PubMed & list_uids=17142384

---------------------------------

Want to start your own business? Learn how on Small Business.

__________________________________________________

[Guest guest]

Hi Sue,

Oh, I was half-way kidding.<g>

Unfortunately, I'm coming up on a year since dx, and they still

haven't found a drug combination that keeps me comfortable, and in

spite of early, aggressive treatment, I've already had significant

changes in my feet during that time. Unfortunately, Enbrel didn't

work very well for me. I'm on Humira now, which seems to be better,

but I still never have a day when RA doesn't get in my way to some

extent, and there are still some days that are pretty bad.

My new rheumatologist (my old one just moved away) says the same

thing that the old one said... That we still have a number of

options left if this isn't the answer. I try to keep a positive

outlook, but I have to say, with each new drug that doesn't work, it

gets a little harder.

>

> > Great. I usually like your post, .<g>

> >

> > I am Anti-CCP positive, which I'd already been told seems to be a

> > predictor of more severe RA. I also started this whole journey

with

> > inflamation in my hips and shoulders, followed soon by knees and

> > wrists. I don't like the sound of this new study. :-?

>

[Guest guest]

Oh, you know I won't do that .<g>

Besides, I still believe that the devil you know is better than the

devil you don't.

> >>

> >> Ann Rheum Dis. 2006 Dec 1; [Epub ahead of print]

> >>

> >>

> >> Arthritis of the large joints, in particular the knee, at first

> > presentation

> >> is predictive for a high level of radiological destruction of

the

> > small

> >> joints in rheumatoid arthritis.

> >>

> >>

> >> Linn-Rasker SP, Van der Helm-van Mil AH, Breedveld FC, Huizinga

TW.

> >>

> >> Leiden University Medical Center, Netherlands.

> >>

> >> OBJECTIVE: To investigate the predictive value of the

distribution

> > of

> >> inflamed joints at first presentation for the severity of the

> > disease course

> >> in RA. METHODS: From 1009 consecutive patients included in the

> > Leiden Early

> >> Arthritis Clinic, 285 patients fulfilled the ACR-criteria for RA

> > within

> >> 1-year of follow-up. Of these, 28 patients achieved remission.

> > Radiographs

> >> of hands and feet were scored according to the Sharp-van der

> > Heijde method

> >> and the 28 patients with the most destructive disease were

> > selected. The

> >> distribution of inflamed joints of the patients with the extreme

> > disease

> >> courses was compared. The association between the distribution

of

> > inflamed

> >> joints and the level of destruction of the joints of hands and

> > feet in the

> >> whole group of RA-patients was assessed using regression

analysis.

> > RESULTS:

> >> Comparison of the patients with extreme disease courses using

> > univariate and

> >> logistic regression analyses revealed that arthritis of the

large

> > joints, in

> >> particular the knee, was associated with severe RA. In the whole

> > group of

> >> RA-patients, the total number of swollen joints and the presence

> > of knee

> >> arthritis associated independently with the level of destruction

> > of the

> >> small joints. RA-patients with knee arthritis had higher C-

> > reactive protein

> >> levels than patients without knee arthritis and investigating

the

> >> distribution of inflamed joints together with other variables

> > yielded the

> >> number of swollen joints, C-reactive protein level, presence of

> > anti-CCP

> >> antibodies and symptom duration as predictors for RA severity.

> >>

> >> CONCLUSION: Arthritis of large joints, in particular the knee,

at

> > first

> >> presentation is associated with a destructive course of RA.

> >>

> >> PMID: 17142384

> >>

> >> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

> > cmd=Retrieve & db=PubMed & list_uids=17142384

>

[Guest guest]

We live in hope!<g>

> >>

> >> Ann Rheum Dis. 2006 Dec 1; [Epub ahead of print]

> >>

> >>

> >> Arthritis of the large joints, in particular the knee, at first

> > presentation

> >> is predictive for a high level of radiological destruction of

the

> > small

> >> joints in rheumatoid arthritis.

> >>

> >>

> >> Linn-Rasker SP, Van der Helm-van Mil AH, Breedveld FC, Huizinga

TW.

> >>

> >> Leiden University Medical Center, Netherlands.

> >>

> >> OBJECTIVE: To investigate the predictive value of the

distribution

> > of

> >> inflamed joints at first presentation for the severity of the

> > disease course

> >> in RA. METHODS: From 1009 consecutive patients included in the

> > Leiden Early

> >> Arthritis Clinic, 285 patients fulfilled the ACR-criteria for RA

> > within

> >> 1-year of follow-up. Of these, 28 patients achieved remission.

> > Radiographs

> >> of hands and feet were scored according to the Sharp-van der

> > Heijde method

> >> and the 28 patients with the most destructive disease were

> > selected. The

> >> distribution of inflamed joints of the patients with the extreme

> > disease

> >> courses was compared. The association between the distribution

of

> > inflamed

> >> joints and the level of destruction of the joints of hands and

> > feet in the

> >> whole group of RA-patients was assessed using regression

analysis.

> > RESULTS:

> >> Comparison of the patients with extreme disease courses using

> > univariate and

> >> logistic regression analyses revealed that arthritis of the

large

> > joints, in

> >> particular the knee, was associated with severe RA. In the whole

> > group of

> >> RA-patients, the total number of swollen joints and the presence

> > of knee

> >> arthritis associated independently with the level of destruction

> > of the

> >> small joints. RA-patients with knee arthritis had higher C-

> > reactive protein

> >> levels than patients without knee arthritis and investigating

the

> >> distribution of inflamed joints together with other variables

> > yielded the

> >> number of swollen joints, C-reactive protein level, presence of

> > anti-CCP

> >> antibodies and symptom duration as predictors for RA severity.

> >>

> >> CONCLUSION: Arthritis of large joints, in particular the knee,

at

> > first

> >> presentation is associated with a destructive course of RA.

> >>

> >> PMID: 17142384

> >>

> >> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

> > cmd=Retrieve & db=PubMed & list_uids=17142384

>

>

>

>

>

>

> ---------------------------------

> Want to start your own business? Learn how on Small

Business.

> __________________________________________________

>

[Guest guest]

,

I hope your rheumy soon finds the right combination for you. I realize

how very lucky I am to get relief, when I read here about the suffering

of many others. I just hope that the Enbrel keeps on working for me. Be

the squeaky wheel that gets the grease. Don't give up, just try to hang

in there.

Sue

On Wednesday, December 13, 2006, at 08:46 AM, Randall wrote:

>

> My new rheumatologist (my old one just moved away) says the same

> thing that the old one said... That we still have a number of

> options left if this isn't the answer. I try to keep a positive

> outlook, but I have to say, with each new drug that doesn't work, it

> gets a little harder.

[Guest guest]

Well, the good thing is that I think that both rheumatologists I've

worked with have stayed right on top of things. Everything I read

about here, they've already done or are doing. So it's patience I

need more than anything else.<g>

> >

> > My new rheumatologist (my old one just moved away) says the same

> > thing that the old one said... That we still have a number of

> > options left if this isn't the answer. I try to keep a positive

> > outlook, but I have to say, with each new drug that doesn't

work, it

> > gets a little harder.

>