Our data show that in almost 70% of RA patients, anti-CCP antibody is present at the early stages of disease. Anti-CCP-positive patients developed significantly more severe radiologic damage than patients who were anti-CCP negative, although in multiple regression analysis the additional predictive value was rather moderate.
Both presented patients and the review of the literature demonstrate that active TB may be complicated by ReA known as Poncet's disease. Early recognition of this rare complication of TB is of major importance to avoid delayed initiation of appropriate treatment.
Objective-To investigate mortality, functional capacity, and prognostic factors for mortality in an inception cohort of patients with recently diagnosed RA followed up for up to 10 years. Methods-The observed mortality of this inception cohort with recently diagnosed RA, was analysed in relation to the expected mortality, calculated with the aid of life tables of the general population of the Netherlands (matched for age and sex). Functional capacity was measured by the Health Assessment Questionnaire. Prognostic factors for mortality were analysed multivariately by the Cox proportional hazards model. Results-Between January 1985 and April 1997, 622 patients entered the study, and were included in the analysis of mortality. The death rate in the first 10 years of the disease was not significantly diVerent from that of the general population. Fifty five patients from the study group died (16% up to 10 years of follow up). The most commonly reported causes of death were of cardiovascular and respiratory origin. The other causes of death could be classified into cancer, sepsis, amyloidosis, leukaemia, renal insuYciency of unknown cause, perforation of the oesophagus, probably related to the treatment with non-steroidal anti-inflammatory drugs, and pancytopenia during aurothioglucose treatment. Functional capacity improved significantly during the first six years compared with the value at start. Statistically significant predictors for death were age at the start and male sex. Conclusions-In contrast with earlier studies performed, no excess mortality in the first 10 years of an inception cohort of patients with RA was seen. In addition, the functional capacity was relatively constant during the first six years after an initial improvement from baseline. Age at start and male sex were the only statistically significant predictors for death. (Ann Rheum Dis 2000;59:954-958)
Objective. Patients with ankylosing spondylitis (AS) are at risk for accelerated muscle loss and reduced physical activity. Accurate data are needed on body composition and physical activity in this patient group. The purpose of this study was to investigate body composition and objectively assessed physical activity in patients with AS. Methods. Twenty-five AS patients (15 men, mean ؎ SD age 48 ؎ 11 years) were compared with 25 healthy adults matched for age, sex, and body mass index. Body composition was measured using a 3-compartment model based on air-displacement plethysmography to assess body volume and deuterium dilution to assess total body water. The fat-free mass index (FFMI; fat-free mass divided by height squared) and the percent fat mass (%FM) were calculated. Daily physical activity was assessed for 7 days using a triaxial accelerometer and physical fitness with an incremental test until exertion on a bicycle ergometer. Blood samples were taken to determine C-reactive protein (CRP) level and tumor necrosis factor ␣. Results. Accelerometer output (kilocounts/day) showed the same physical activity level for patients and controls (mean ؎ SD 319 ؎ 105 versus 326 ؎ 66). There was no difference in the FFMI or %FM between the patients and controls. Physical activity was positively related to the FFMI (partial R ؍ 0.38, P ؍ 0.01) and inversely related to CRP level (R ؍ ؊0.39, P < 0.01), independent of group. CRP level was inversely related to the FFMI, but the effect was less strong than with physical activity (partial R ؍ ؊0.31, P ؍ 0.03). Conclusion. Daily physical activity may help preserve fat-free mass in patients with AS.
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