RESEARCH - The temporal relationship of Raynaud's phenomenon and features of connective tissue disease in RA

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Journal of Rheumatology

Oct 2008

The Temporal Relationship of Raynaud's Phenomenon and Features of

Connective Tissue Disease in Rheumatoid Arthritis

JANET E. POPE, JAMAL AL-BISHRI, HAFSAH AL-AZEM, and JANINE M. OUIMET

ABSTRACT.

Objective. In a prospective cohort study we examined the relationship

between Raynaud's phenomenon (RP) onset and other connective tissue

disease (CTD) characteristics in rheumatoid arthritis (RA) to

determine if RP is predictive of RA severity and associated with other

CTD signs, and if late onset RP in RA has an effect on prognosis

compared to other patients with RA.

Methods. Using a standardized assessment, data were collected on 328

subjects with RA [mean age 60.3 ± 0.7; 77% women; 76% erosions, 75%

positive rheumatoid factor (RF)] seen at one London, Ontario,

rheumatology clinic. The data included RA disease duration; presence

and duration of RP; presence of nodules, joint damage, telangiectasia,

and sclerodactyly; and RF status (+/-), RF value, antinuclear

antibodies, and E-nuclear antibodies.

Results. The mean RA disease duration was 12 ± 0.6 years. Seventy-one

(22%) had RP and the mean RP duration was 9.2 ± 1.5 years. Patients

presented with RP a mean of 3.8 ± 1.4 years after the diagnosis of RA.

RP status was positively associated with the presence of sclerodactyly

(p < 0.001), but not nodules or erosions. Higher RF values were

associated with longer RA disease duration (p < 0.002) and longer RP

duration (p < 0.01).

Conclusion. Idiopathic RP may have a different clinical effect on RA

than secondary RP; the latter is correlated with more severe RA.

Sclerodactyly is associated with erosive arthritis and RP in RA.

Higher RF values were indicative of increased RA and RP duration.

http://jrheum.com/abstracts/abstracts08/13/104.html

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