RESEARCH - Disease activity and the course of wrist joint deterioration over 10 years in patients with early RA

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Mod Rheumatol. 2008 Aug 30.

Disease activity and the course of wrist joint deterioration over 10

years in the patients with early rheumatoid arthritis.

Toyohara I, Ishikawa H, Abe A, Nakazono K, Murasawa A.

Department of Rheumatology, Niigata Rheumatic Center, 1-2-8 Honcho,

Shibata, Niigata, 957-0054, Japan.

The objectives of this study were to evaluate the course of

radiographic deterioration of the wrist joint with rheumatoid

arthritis (RA), and to determine the influence of disease activity on

its deterioration. A retrospective study was performed on 122 wrists

in 66 patients, who started treatment using disease-modifying

antirheumatic drugs within the first year of the disease and followed

for more than 10 years without surgical intervention. The mean disease

activity score (DAS28-CRP[3]) was high during the first 2 years,

followed by a decrease and a flattening of the curve of disease

activity. Generally, carpal collapse progressed more in the early

stage and decreased linearly over 10 years. Individually, continuous

high disease activity and progression in radiographic damage were

observed in carpal collapsed groups from early stage of the disease.

The cut-off values of the mean DAS28-CRP(3) during year 0-2, which

indicated progression to Larsen grade III or more and Schulthess type

I (ankylosis) or III (disintegration) at year 10 were 3.34

(sensitivity: 70.9% and specificity: 72.1%) and 3.63 (sensitivity:

74.3% and specificity: 77.0%), respectively. In patients with RA,

deterioration of the wrist joint was influenced by disease activity.

Identifying this activity and the course of wrist progression may be

useful in predicting wrist deterioration.

PMID: 18758892

http://www.ncbi.nlm.nih.gov/pubmed/18758892

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