Objective To describe the osteoarthritis study population of CHECK (Cohort Hip and Cohort Knee) in comparison with relevant selections of the study population of the Osteoarthritis Initiative (OAI) based on clinical status and radiographic parameters. Methods In The Netherlands a prospective 10-year follow-up study was initiated by the Dutch Arthritis Association on participants with early osteoarthritis-related complaints of hip and/or knee: CHECK. In parallel in the USA an observational 4-year follow-up study, the OAI, was started by the National Institutes of Health, on patients with or at risk of symptomatic knee osteoarthritis. For comparison with CHECK, the entire cohort and a subgroup of individuals excluding those with exclusively hip pain were compared with relevant subpopulations of the OAI. Results At baseline, CHECK included 1002 participants with in general similar characteristics as described for the OAI. However, significantly fewer individuals in CHECK had radiographic knee osteoarthritis at baseline when compared with the OAI (p<0.001). In contrast, at baseline, the CHECK cohort reported higher scores on pain, stiffness and functional disability (Western Ontario and McMaster osteoarthritis index) when compared with the OAI (all p<0.001). These differences were supported by physical health status in contrast to mental health (Short Form 36/12) was at baseline significantly worse for the CHECK participants (p<0.001). Conclusion Although both cohorts focus on the early phase of osteoarthritis, they differ significantly with respect to structural (radiographic) and clinical (health status) characteristics, CHECK expectedly representing participants in an even earlier phase of disease.

Dutch College of Health Insurance Companies, Schering-Plough, and Janssen.

Objective. To predict the 2-year course of activity limitations in patients with early knee and/or hip osteoarthritis (OA). Methods. The Cohort Hip & Cohort Knee (CHECK) study is a prospective followup study. The CHECK cohort, comprising participants (n ‫؍‬ 1,002) with early OA-related knee and/or hip symptoms, was followed for 2 years. Participants completed questionnaires and underwent physical, laboratory, and radiographic examination. Regression models were used to examine whether baseline variables predicted the course of activity limitations as measured with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Analyses were performed separately for participants with knee symptoms and participants with hip symptoms. Results. After 2 years of followup, activity limitations slightly decreased. Large between-subject variation was observed in WOMAC change scores. In participants with knee symptoms, young age, non-Western ethnicity, bilateral hip pain, morning stiffness in the knee, high comorbidity count, high body mass index, high bodily pain, poor general health perception, and pain coping strategy were associated with a poor 2-year outcome on activity limitations. In participants with hip symptoms, few activity limitations at baseline, bilateral hip pain, morning stiffness in the knee, high comorbidity count, low active hip flexion, poor general health perception, and pain coping strategy were associated with a poor 2-year outcome on activity limitations. Conclusion. After 2 years of followup, large between-subject variation was observed in the course of activity limitations. The course of activity limitations is to some extent already predictable at an early stage of knee and hip OA.

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Objective. To evaluate the efficacy of infliximab plus methotrexate (MTX) as induction therapy in patients with early rheumatoid arthritis (RA).Methods. Disease-modifying antirheumatic drug (DMARD)-naive patients with active, early RA who were included as group 4 of the BeSt study were initially treated with infliximab (3 mg/kg) in combination with MTX (25 mg/week). The Disease Activity Score (DAS) was measured every 3 months. In patients with persistent low disease activity (DAS <2.4) for at least 6 months, the infliximab dosage was tapered and finally discontinued; the MTX dosage then was tapered to 10 mg/week. In patients with a DAS of >2.4, the infliximab dosage was increased (maximum 10 mg/kg), and they were subsequently switched to another DMARD. Except for intraarticular administration, corticosteroids were not permitted. Functional ability and the modified Sharp/ van der Heijde score were determined after 2 years of therapy.Results. Of the 120 patients, 67 responders (56%) had persistent low disease activity and discontinued infliximab after a median of 9.9 months, with a median