Radiological progression of joint damage in a longitudinal cohort of early DMARD-treated rheumatoid arthritis patients followed for 10 years

• Published in: Scandinavian journal of rheumatology Vol. 33; no. 3; pp. 162 - 166
• Main Authors: Wick, MC, Anderwald, C, Weiss, RJ, Imhof, H, Kainberger, F, Smolen, JS
• Format: Journal Article
• Language: English
• Published: Colchester Informa UK Ltd 01.05.2004; Taylor & Francis
• Subjects: acute-phase response; Adult; Antirheumatic Agents - therapeutic use; Arthritis, Rheumatoid - complications; Arthritis, Rheumatoid - drug therapy; Arthritis, Rheumatoid - pathology; Biological and medical sciences; Cohort Studies; Disease Progression; Diseases of the osteoarticular system; DMARDs; Female; Humans; Inflammatory joint diseases; Joint Diseases - diagnostic imaging; Joint Diseases - etiology; Larsen erosion score; Male; Medical sciences; Medicin och hälsovetenskap; Middle Aged; radiographs; Radiography; Reference Values; rheumatoid arthritis progression; Human; Immunopathology; Prognosis; Diseases of the osteoarticular system; Rheumatology; Autoimmune disease; Inflammatory joint disease; Joint; Chronic; Treatment; Cohort study; Rheumatoid arthritis; Evolution; Early
• ISSN: 0300-9742; 1502-7732
• DOI: 10.1080/03009740310004874

Objective: The efficacy of DMARD therapy in rheumatoid arthritis (RA) can be judged by radiological analysis. This study aimed to determine the time-dependent progression of joint damage, acute-phase response, and rates of radiologic progression in early DMARD-treated RA patients over 10 years. Patients and methods: We evaluated outpatient records, and radiographs of hands and feet of 54 early RA patients on DMARDs for 10 years. Radiographs were quantified by the Larsen method using recently developed quantification software. Results: Radiological damage attenuated, with disease progression from baseline to Year 10 [correlation coefficient (r)=0.95, probability (p)<0.001]. Radiographic scores progressed more rapidly during the first 5 years than thereafter. Cumulative erythrocyte sedimentation rate (ESR) was strongly correlated with radiological progression (p<0.001, r=0.88). Conclusion: Our findings reveal a higher amount of radiographic RA progression during the first years of DMARD treatment. Thus, our data provide strong evidence for the importance of both early DMARD therapy and continuous radiographic assessments in RA.