RESEARCH - Radiological damage in RA patients in sustained remission

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Ann Rheum Dis. 2006 Aug 25; [Epub ahead of print]

Radiological damage in rheumatoid arthritis patients in sustained remission.

Cohen G, Gossec L, Dougados M, Cantagrel A, Goupille P, Daures JP, Rincheval

N, Combe B.

Centre Hospitalier Universitaire Lapeyronie Universite Montpellier I,

France.

OBJECTIVE: To assess the radiological damage progression in recent

rheumatoid arthritis (RA) patients in sustained remission. METHODS: A cohort

of 191 patients with active early (< 1 year) RA was prospectively assessed

at baseline, 3 and 5 years by the disease activity score (DAS) and the

Sharp - van der Heijde radiographic damage score. Patients in remission (DAS

< 1.6) at the 3 and 5 years time points were compared with patients with a

persistently active RA by Wilcoxon's signed rank test. RESULTS: Fifty seven

patients died, were lost to follow up or had incomplete data; 30 (15.7% of

completers) patients were in remission at 3 and 5 years. The Sharp score in

these 2 groups was not statistically different at baseline (p=0.15) but was

lower in the remission group at 5 years (p=0.0047). The median

(interquartile range, IQR) radiographic score increased from 0.5 (0-7) at

baseline to 2.5 (0-14) after 5 years for the remission group (p=0.18) and

from 2 (0-7) to 13 (3-29) in the group with active RA (p<0.0001). Five

(16.7%) patients in remission had relevant progression of radiographic

damage (i.e. progression > 4.1 points) and 6 (20%) presented new erosions in

a previously unaffected joint between the third and the fifth year.

CONCLUSION: Early RA patients in sustained remission did not present

statistically significant radiographic degradation at the group level;

nevertheless, 16.7% of these patients did present degradation. Absence of

progression should be part of the remission definition in RA.

PMID: 16935911

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

6935911

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