RESEARCH - The Italian registry of aggressive RA - the GIARA project

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J Rheumatol. 2007 Dec;34(12):2374-81. Epub 2007 Nov 15.

The Italian registry of aggressive rheumatoid arthritis -- the GIARA project.

Marchesoni A, Govoni M, Valentini G, Valesini G, Salaffi F, Macchioni

P, Alberighi OD, Ferraccioli G; GIARA.

UOC Rheumatology Day Hospital, G. Pini Orthopaedic Institute,

University of Milan, Milan, Italy.

OBJECTIVE: In 1999, the Italian Society of Rheumatology started a

project to determine the prevalence and clinical characteristics of

aggressive rheumatoid arthritis (ARA). METHODS: For 1 year, all

patients with RA for > 5 years and referred to participating centers

were entered in a registry and classified as having ARA if they

fulfilled the following criteria: 10 swollen joints for at least 6

weeks, positive rheumatoid factor (RF), and at least one bone erosion

(if disease duration of 2 years); (a) RF-positive and having 10

swollen joints or at least one newly eroded joint, or ( if

RF-negative, having 10 swollen joints and at least one newly eroded

joint (if disease duration > 2 to < 5 years). RESULTS: The 94

participating centers enrolled 1218 patients with RA, 1130 of whom had

enough data to be classified as ARA (29.0%) or non-ARA (71.0%). The

frequency of ARA was 15% in the 2-year group and 63% in the > 2 to <

5-year group, but 35% of the patients in the 2-year group had

erosions. Bone erosions were associated with disease duration, a

Health Assessment Questionnaire value > 1.5, female sex, and RF

positivity. Conditions other than RA were recorded in about 50% of the

patients, and only 30% 40% were taking disease modifying antirheumatic

drugs.

CONCLUSION: In an Italian RA population, the GIARA (Gruppo Italiano

Artrite Reumatoide Aggressiva) criteria for ARA were met by 15% of the

patients with disease duration of 2 years, but erosions were seen in

35%. Upon referral, most of the RA patients were inadequately treated

and had other conditions.

PMID: 18050379

http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve & db=PubMed & list_uids=180503\

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