Early rheumatoid arthritis —onset, course, and outcome over 2 years
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Eighty-nine patients, 33 men and 56 women, with early definite rheumatoid arthritis were followed for 2 years. Two-thirds were seropositive. About 1/3 were eventually treated with second line drugs. The disease mostly had an insidious onset initially involving the finger joints. Early remission occurred in 16%. Patient relevant measures such as pain, patient's overall assessment of disease activity and anxiety decreased significantly. Disability evaluated by the HAQ disability index remained at a low level. The joint damage score (JDS) in hands and feet increased steadily and only 18% were nonerosive after 2 years. One-third developed hand deformities which was associated with higher JDS. A joint function index (SOFI) correlated significantly with JDS. Twenty-eight percent had a slower rate of joint damage progression the second year. There was no significant correlation between JDS and disease duration. Six patients developed rapidly progressive damage in larger joints, five in the hip joints and one in the shoulder joint, all requiring joint replacement. The ability to predict outcomes with clinical and laboratory variable obtained at entry was of limited clinical usefulness. By applying discriminant analyses 67%–80% of the cases who fared worst regarding clinical, functional, and radiological features could be correctly classified.
Key wordsEarly RA HAQ SOFI Radiology Anxiety Depression Outcome Prognosis
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- 2.Ropes MW, Bennett GA, Cobb S, Jacox R, Jessar RA (1959) Diagnostic criteria for rheumatoid arthritis. Ann Rheum Dis 18: 49–53Google Scholar
- 7.Mallya RK, Mace BEW (1981) The assessment of disease activity in rheumatoid arthritis using a multivariate analysis. Rheum Rehab 20: 14–17Google Scholar
- 9.Steinbrocker O, Traeger CH, Batterman RC (1949) Therapeutic criteria in rheumatoid arthritis. JAMA 140: 659–662Google Scholar
- 12.Larsen A, Dale K, Eek M (1977) Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films. Acta Radiol Diagnosis 18: 481–491Google Scholar
- 13.Eberhardt KB, Truedsson L, Pettersson H, Svensson B, Stigsson L, Eberhardt JL, Wollheim FA (1990) Disease activity and joint damage progression in early rheumatoid arthritis —relation to IgG, IgA and IgM rheumatoid factor. Ann Rheum Dis (in press)Google Scholar
- 15.Laurell CB (1972) Electroimmunoassay. Scand J Clin Lab Invest 29 [Suppl 124]: 21–37Google Scholar
- 16.Ball J (1950) Serum factor in rheumatoid arthritis agglutinating sensitized sheep red cells. Lancet II: 520–524Google Scholar
- 34.Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS, Medsger Jr TA, Mitchell DM, Neustadt DH, Pinals RS, Schaller JG, Sharp JT, Wilder RL, Hunder GG (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31: 315–324PubMedGoogle Scholar