Predicting factors for severity of rheumatoid arthritis: a prospective multicenter cohort study of 172 patients over 3 years

Abstract

Rheumatoid arthritis may take an unfavourable course leading to rapid functional decline in a certain percentage of patients. Early identification of these patients is desirable. The aim of this study was to evaluate clinical and laboratory parameters for their value in the prediction of bad outcome. A total of 172 patients with early arthritis were followed for 3 years. Higher initial values for erythrocyte sedimentation rate, IgG and IgM rheumatoid factor, serum concentration of cartilage oligomeric matrix protein, Health Assessment Questionnaire score, Larsen score of feet, disease activity score, and swollen and tender joint count predicted worse outcome. An association with the presence of IgA rheumatoid factor or anti-cyclic-citrullinated peptide could not be established. We conclude that prognosis in an individual with rheumatoid arthritis depends on many factors. The determination of independent prognostic factors for progression of rheumatoid arthritis is a valuable tool in early arthritis to select patients for more aggressive therapy.

Multi-Dimensional Health Assessment Questionnaire in China: Reliability, Validity and Clinical Value in Patients with Rheumatoid Arthritis

“…Discirminant validity was estimated in patients distributed into two different groups: patients that were active versus inactive (remission) in disease activity groups by the cutoff value of 2.6 according to DAS28, and patients with disability versus without disability groups by the cutoff value of 1 in functional class. Clinical values were assessed by comparing RAPID3 and the components with disease characteristics and agreement of RAPID3 with Disease Activity core-28(DAS28) [24] and with Clinical Disease Activity Index(CDAI) [25] Categories for disease activities were also assessed according to the statistic methods by Pincus T [13] which will be shown in detail in the following statistical analyses.…”

Trajectory of intensive treat-to-target disease modifying drug regimen in an observational study of an early rheumatoid arthritis cohort

“…Factors associated with poor radiological outcome include smoking, rheumatoid factor (RF) positivity, the presence of anticitrullinated peptide autoantibodies (ACPA), HLA-DR genotype, low socioeconomic status and bone oedema on MRI 5–9. However, poor outcome measured by HAQ was associated with high baseline disease activity or HAQ, including RF, DAS28 score, tender and swollen joint counts, ESR and CRP 10 11. However, in treat-to-target protocols, such as was used in the TICORA trial and which occur in real-life clinic settings, decision-making about dose and drugs is a dynamic process, responsive to the patient's disease activity over time 12.…”

Early changes in bone mineral density measured by digital X-ray radiogrammetry predict up to 20 years radiological outcome in rheumatoid arthritis

“…Early bone loss is a risk factor, in addition to other known risk factors. Thus, although statistically significant predictive value for RA prognosis can be found for several early findings such as the presence of rheumatoid factor, anticyclic citrullinated peptide antibody, elevated ESR level and cartilage oligomeric matrix protein level, their value in clinical decisions regarding treatment of the individual patient must not be overemphasized [22-29]. Treatment decisions rely heavily on several aspects not covered by conventional predictive analyses, such as perceived pain, working situation, deteriorating function and so on.…”