RESEARCH - Repair of joint erosions in RA: prevalence and patients characteristics in a large inception cohort

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Ann Rheum Dis. 2009 May 18.

Repair of joint erosions in rheumatoid arthritis: prevalence and

patient characteristics in a large inception cohort.

van der Linden MP, Boja R, Klarenbeek NB, Huizinga TW, van der Heijde

DM, van der Helm-van Mil AH.

Department of Rheumatology, Leiden University Medical Center, Netherlands.

BACKGROUND: Joint destruction in rheumatoid arthritis (RA) was until

recently seen as an irreversible state. Lately, it was defined that

repair of bone erosions occurs; however little is known about its

prevalence. This study investigates the frequency of repair and

patients characteristics associated with repair in an inception

cohort. PATIENTS AND

METHODS: 250 RA-patients, included in the Leiden Early Arthritis

Clinic between 1993-2000 and treated with conventional DMARD-therapy,

were studied (mean follow-up 10.1 years). Yearly made radiographs were

scored using the Sharp-van der Heijde method, initially aware of the

chronology. Patients with a negative change in erosion scores on

subsequent radiographs were selected and their series of radiographs

were rescored with concealed time sequence by three readers. Repair

was defined as agreement of two readers in having a negative change in

erosion scores that persisted for at least two years.

RESULTS: Repair was identified in 32 joints in 18 patients (7.2%).

Patients with repair had more frequent autoantibodies (RF,ACPA) and a

higher level of joint destruction. In the joints with repair arthritis

was absent in the two years preceding repair.

CONCLUSIONS: Repair occurred in 7.2% of the RA-patients, particularly

in clinically inactive joints in patients with severe destructive

disease.

PMID: 19454405

http://www.ncbi.nlm.nih.gov/pubmed/19454405

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