RESEARCH - Declines in ESR in patients with RA over the second half of the 20th century

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J Rheumatol. 2009 Jun 16.

Declines in Erythrocyte Sedimentation Rates in Patients with

Rheumatoid Arthritis Over the Second Half of the 20th Century.

Abelson B, Sokka T, Pincus T.

From the New York University Hospital for Joint Diseases, New York,

New York, USA; and Jyväskylä Central Hospital, Jyväskylä, Finland.

OBJECTIVE: To analyze baseline erythrocyte sedimentation rates (ESR)

in cohorts of patients with rheumatoid arthritis (RA), which had been

included in a review concerning longterm mortality, in reports

published between 1973 and 2008, with baseline observations between

1954 and 2000.

METHODS: A computer search and complementary review of the literature

had identified 84 unique cohorts with RA for which mortality over 5-40

years was reported. Baseline ESR data were available for 23 of the 84

cohorts. Mean and median ESR, age, disease duration, and rheumatoid

factor (RF) status were compiled and analyzed in tertiles according to

first year of patient recruitment.

RESULTS: Among 7 cohorts recruited initially between 1954 and 1980,

median ESR at baseline was 47 mm/h (mean 50 mm/h, range 43-66),

compared to median 38 mm/h (mean 41 mm/h, range 34-64) among 8 cohorts

recruited between 1981 and 1984, and median 36 mm/h (mean 35 mm/h,

range 28-42) among 8 cohorts recruited between 1985 and 1996. The

lowest mean ESR among 7 cohorts with baseline in 1980 or earlier was

43 mm/h, and the highest reported mean ESR among 8 cohorts recruited

after 1985 was 42 mm/h. In 3 cohorts recruited after 1985 from Sweden,

Finland, and Spain, mean baseline ESR was < 30 mm/h.

CONCLUSION: Mean ESR fell by 30% in cohorts of patients with RA

recruited before 1981 compared to cohorts recruited after 1984. This

decline may reflect changes in both the natural history and approaches

to therapy of RA.

PMID: 19531746

http://www.ncbi.nlm.nih.gov/pubmed/19531746

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