RESEARCH - Level of radiographic damage and progression are determinants of physical function: TEMPO

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Published Online First: 18 January 2008. doi:10.1136/ard.2007.081331

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EXTENDED REPORTS

Level of radiographic damage and radiographic progression are

determinants of physical function: a longitudinal analysis of the

TEMPO trial

D van der Heijde 1, R Landewé 2, R van Vollenhoven 3, S Fatenejad 4, L

Klareskog 3

1 Leiden University Medical Centre, Leiden, The Netherlands

2 University Hospital, Maastricht, The Netherlands

3 Karolinska University Hospital, Stockholm, Sweden

4 Wyeth Research, Collegeville, Pennsylvania, USA

Background: Many studies have examined the relationship between

long-term radiographic damage and physical function. However, it is

not known if short-term radiographic progression is also associated

with physical function.

Aim: To investigate the longitudinal relationship between physical

function and both the level of radiographic damage and the

radiographic progression rate in patients with early or advanced

active rheumatoid arthritis.

Methods: The database for the 2-year Trial of Etanercept and

Methotrexate with Radiographic Patient Outcomes (TEMPO) was used for

this study. Physical function was measured by the Health Assessment

Questionnaire (HAQ) score at baseline, 6 months and 1 and 2 years.

Radiographs of the hands and feet, taken at the same time points, were

scored by the van der Heijde-modified Total Sharp Score (TSS). The HAQ

score was modelled using generalised mixed linear modelling by TSS or

progression in TSS (interval 0–1 year and 1–2 years) adjusted for age,

sex, treatment and disease activity.

Results: After adjustment for age, sex and disease activity, both TSS

and the change in TSS (progression rate) were significant determinants

of the HAQ score. When radiographic progression was divided into four

categories (negative, zero, minor and greater progression), results

showed that HAQ scores tended to be higher with a higher rate of

progression. Patients with negative progression scores had lower HAQ

scores than patients with positive progression scores.

Conclusions: Patients with greater radiographic damage, and those with

recent radiographic progression, have a higher degree of disability.

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Read the entire article here:

http://ard.bmj.com/cgi/content/full/67/9/1267

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