Long-term course and outcome of functional capacity in rheumatoid arthritis: The effect of disease activity and radiologic damage over time

Drossaers-Bakker, K.W.; Buck, M. de; Zeben, Derkjen van; Zwinderman, Aeilko H.; Breedveld, F. C.; Hazes, Johanna M. W.

doi:10.1002/1529-0131(199909)42:9<1854::aid-anr9>3.0.co;2-f

Cited by 347 publications

(247 citation statements)

References 29 publications

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“…RANKL acts as a potent osteoclast activator producing bone erosions in adjuvant arthritis (2). The limited predictive power of RANKL in our study may show that osteoprotegerin, its endogenous inhibitor, modifies RANKL-induced joint damage, in addition to the interaction with IFN␥ above.…”

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confidence: 74%

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Synovial membrane cytokine expression is predictive of joint damage progression in rheumatoid arthritis: A two‐year prospective study (the DAMAGE study cohort)

Kirkham

Lassere

Edmonds

et al. 2006

Arthritis & Rheumatism

308

222

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confidence: 74%

“…Rheumatoid arthritis (RA) is characterized by progressive irreversible joint damage resulting in increasing disability (1,2). However, joint damage accumulation is highly variable, differing up to 10-fold between individuals after 8-12 years of disease (3,4).…”

mentioning

confidence: 99%

Synovial membrane cytokine expression is predictive of joint damage progression in rheumatoid arthritis: A two‐year prospective study (the DAMAGE study cohort)

Kirkham

Lassere

Edmonds

et al. 2006

Arthritis & Rheumatism

308

222

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“…This process can be measured by quantifying the changes in joint space narrowing and erosions that are visible on serial plain radiographs (2). Radiographic joint damage is associated with long-term functional disability (3) and is the accepted assessment tool for monitoring clinical progression and long-term response to therapy (4). Radiographic progression develops over many months and years, however, and is not suitable for assessment of treatment efficacy over short periods.…”

mentioning

confidence: 99%

Early changes in serum type ii collagen biomarkers predict radiographic progression at one year in inflammatory arthritis patients after biologic therapy

Mullan¹,

Matthews²,

Bresnihan³

et al. 2007

Arthritis & Rheumatism

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Objective. To investigate whether short-term changes in serum biomarkers of type II collagen degradation (C2C) and types I and II collagen degradation (C1,2C), as well as the biomarker for the synthesis of type II procollagen (CPII) can predict radiographic progression at 1 year following initiation of biologic therapy in patients with inflammatory arthritis.Methods. Serum levels of biomarkers were measured at baseline and at 1, 3, 6, 9, and 12 months after initiation of biologic therapy. A composite score reflecting changes from baseline in all 3 biomarkers (⌬COL) was calculated. Associations with clinical responses according to the 28-joint count Disease Activity Score and with radiographic progression according to the modified Sharp/van der Heijde score (SHS) were assessed.Results. The 1-year increase in the SHS correlated with the 1-month change in C2C results (r ‫؍‬ 0.311, P ‫؍‬ 0.028) and the ⌬COL score (r ‫؍‬ 0.342, P ‫؍‬ 0.015). Radiographic progression was predicted by increases in serum C2C at 1 month (P ‫؍‬ 0.031). The ⌬COL score was significantly associated with 1-year radiographic progression after 1 (P ‫؍‬ 0.022), 3 (P ‫؍‬ 0.015), 6 (P ‫؍‬ 0.048), and 9 (P ‫؍‬ 0.019) months of therapy. Clinical remission was predicted by 1-month decreases in serum levels of C2C (P ‫؍‬ 0.008) and C1,2C (P ‫؍‬ 0.036). By regression analysis, 1-month changes in C2C, C1,2C, and CPII levels were independently associated with, and correctly predicted radiographic outcome in, 88% of the patients.Conclusion. Short-term changes in serum levels of collagen biomarkers following initiation of biologic therapy may better predict long-term clinical and radiographic outcomes. These collagen biomarkers may therefore be valuable new early indicators of short-term biologic treatment efficacy in clinical trials and in individual patients with inflammatory erosive arthritis.Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are forms of progressive inflammatory arthritis characterized by pain and progressive destruction of the joints. Joint destruction occurs when inflamed synovial tissue erodes and degrades adjacent cartilage and bone through the action of locally produced cytokines and metalloproteinases (1). This process can be measured by quantifying the changes in joint space narrowing and erosions that are visible on serial plain radiographs (2). Radiographic joint damage is associated with long-term functional disability (3) and is the accepted assessment tool for monitoring clinical progression and long-term response to therapy (4). Radiographic progression develops over many months and years, however, and is not suitable for assessment of treatment efficacy over short periods.

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“…Our bare model had the weakest fit, and adding variables of disease characteristics (medications, ESR, Patient Activity Scale, and DAS28) substantially improved model fit in the administrative and clinic models. Previous studies have shown disease characteristics, rather than comorbidity, to be more closely related to outcomes (28,35). This explains why the comorbidity indices had maximal improvement in model fit in the bare model and progressively less improvement in the administrative and clinic models.…”

Section: Discussionmentioning

confidence: 92%

Validation of the Rheumatic Disease Comorbidity Index

England

Sayles

Mikuls

et al. 2015

Arthritis Care & Research

206

156

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Objective. There is no consensus on which comorbidity index is optimal for rheumatic health outcomes research. We compared a new Rheumatic Disease Comorbidity Index (RDCI) with the Charlson-Deyo Index (CDI), Functional Comorbidity Index (FCI), Elixhauser Total Score (ETS), Elixhauser Point System (EPS), and a simple comorbidity count (COUNT) using a US cohort of rheumatoid arthritis (RA) patients. Methods. Using administrative diagnostic codes and patient self-reporting, we tested predictive values of the RDCI, CDI, FCI, ETS, EPS, and COUNT for 2 outcomes: all-cause mortality and physical functioning. Indices were compared using 3 models: bare (consisting of age, sex, and race), administrative (bare plus visit frequency, body mass index, and treatments), and clinic (administrative plus erythrocyte sedimentation rate, nodules, rheumatoid factor positivity, and patient activity scale). Results. The ETS and RDCI best predicted death, with FCI performing the worst. The FCI best predicted function, with ETS and RDCI performing nearly as well. CDI predicted function poorly. The order of indices remained relatively unchanged in the different models, though the magnitude of improvement in Akaike's information criterion decreased in the administrative and clinic models. Conclusion. The RDCI and ETS are excellent indices as a means of accounting for comorbid illness when the RArelated outcomes of death and physical functioning are studied using administrative data. The RDCI is a versatile index and appears to perform well with self-report data as well as administrative data. Further studies are warranted to compare these indices using other outcomes in diverse study populations.

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Long-term course and outcome of functional capacity in rheumatoid arthritis: The effect of disease activity and radiologic damage over time

Abstract: Functional capacity is strongly influenced by disease activity throughout the course of RA. Even in longstanding RA, disease activity proves to be the main determinant of the HAQ score for functional capacity.

Cited by 347 publications

References 29 publications

Synovial membrane cytokine expression is predictive of joint damage progression in rheumatoid arthritis: A two‐year prospective study (the DAMAGE study cohort)

Synovial membrane cytokine expression is predictive of joint damage progression in rheumatoid arthritis: A two‐year prospective study (the DAMAGE study cohort)

Early changes in serum type ii collagen biomarkers predict radiographic progression at one year in inflammatory arthritis patients after biologic therapy

Validation of the Rheumatic Disease Comorbidity Index

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