RESEARCH - Course of radiographic damage over 10 years in a cohort with early RA

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Ann Rheum Dis. 2003 Jul;62(7):611-6.

Course of radiographic damage over 10 years in a cohort with early

rheumatoid arthritis.

Department of Rheumatology, Lund University Hospital, Sweden Department of

Radiology, Lund University Hospital, Sweden. elisabet.lindqvist@...

OBJECTIVE: To investigate development of radiographic damage in hands and

feet of patients with early rheumatoid arthritis (RA) monitored

prospectively for 10 years, and to search for prognostic factors. PATIENTS

AND METHODS: 181 patients with early RA (mean disease duration one year)

were assessed annually with radiographs of hands and feet during years 0-5

and at year 10. Radiographs were evaluated according to Larsen (range

0-200). Predictive factors for progressive disease for years 0-5 and 5-10

were evaluated by logistic regression analyses. RESULTS: 82/168 (49%)

patients had erosions at inclusion and almost all became erosive with time

(90% after two years and 96% after 10 years). Radiographic progression was

most rapid during the first two years and 75% of all damage occurred during

the first five years. The median Larsen score increased from 6 at inclusion

to 41 after five years and 54 after 10 years. Only 5.3% of all evaluated

joints became maximally eroded, the second metacarpophalangeal joint being

the most commonly affected. Mean ESR during the first three months and

rheumatoid factor status were significant predictors for radiographic

progressive disease, it was not possible to predict non-progressive disease.

CONCLUSIONS: Joint damage in hands and feet developed early and progression

was most rapid during the first years of disease. The different rates of

progression at different stages should be considered in the design of trials

of drugs aimed at retarding joint damage. Disease activity at study start

influenced the degree of joint damage during the entire 10 years.

PMID: 12810421

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus & db=pubmed & cmd=R\

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