Prognostic value of early features in rheumatoid disease.

Fleming, A; Crown, June; Corbett, Mary

doi:10.1136/bmj.1.6020.1243

Cited by 90 publications

(27 citation statements)

References 7 publications

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“…In comparison with younger patients the only difference recognized was a higher degree of joint impairment as measured by SOFI not causing increased disability. This finding is in contrast to Flemming et al [20,37] who observed that older patients had an adverse prognosis as measured by FC, joint involvement, grip strength, and morning stiffness.…”

Section: Discussioncontrasting

confidence: 84%

“…A family history of RA did not influence the prognosis, a finding in accordance with previous investigators [37]. Feigenbaum et al [38] have reported a better prognosis in the male sex which could not be confirmed in the present study or by Flemming et al [20,37].…”

Section: Discussionsupporting

confidence: 83%

“…The results of the analyses concerning prognosis could only be related to a few reports with a comparable length of follow-up [20,21,[37][38][39].…”

Section: Discussionmentioning

confidence: 98%

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Early rheumatoid arthritis —onset, course, and outcome over 2 years

et al. 1990

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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.

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Section: Discussioncontrasting

confidence: 84%

Section: Discussionsupporting

confidence: 83%

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Early rheumatoid arthritis —onset, course, and outcome over 2 years

et al. 1990

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“…Combining RF and GAL(0) improved this discrimination to 91% (sensitivity 90%, specificity 95%, positive predictive value 94%). As Table 3 indicates, of 18 patients in whom RF was negative (i,e., RAHA titer < I :40) and the GAL(0) value was at or below the age-corrected mean, 16 were in the non-RA group. Five patients with RA were seronegative for RF at study entry; 3 of them had raised GAL(0) levels.…”

Section: High Levels Of Agalactosyl Igg (Gal[o])mentioning

confidence: 96%

Agalactosyl IgG: An aid to differential diagnosis in early synovitis

Young

Sumar

Bodman

et al. 1991

Arthritis & Rheumatism

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Sixty consecutive patients presenting with early‐onset synovitis were studied by measuring rheumatoid factor (RF) titers and the percentage of oligosaccharide chains attached to the Cγ2 domain of IgG that lack galactose (GAL[0]). After 2 years of followup, 39 patients (65%) had developed rheumatoid arthritis (RA), and 21 had developed a variety of other inflammatory joint diseases. A combination of RF positivity and GAL(0) levels above the age‐corrected mean gave a positive predictive value for a diagnosis of RA in 94% of these patients. These observations may well have clinical utility.

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“…Those with mild, slowly progressive synovitis do not, in contrast to those with inexorably progressive disease causing severe joint destruction within months, who do. To detect the deserving patients, while sparing those with milder forms of the disease, predictors of poor functional outcome are needed (60)(61)(62)(63)(64). Two common predictive variables that have been used in most series over long periods are 1 acute phase response (APR), 2 active joint score [Ritchie score (6511.…”

Section: Patient Assessmentmentioning

confidence: 99%

Therapeutic progress I: Current treatment of rheumatoid arthritis

Gittoes

1994

J Clin Pharm Ther

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SUMMARY Over recent years the pharmacological treatment strategy for rheumatoid arthritis (RA) has changed. An early, aggressive approach has been adopted with a view to maintaining functional capacity. The changing role of nonsteroidal antiinflammatory agents is discussed in the light of the potential toxicity of this class of drugs. The current use of second‐line agents is dealt with in depth and includes guidelines to patient monitoring. Particular attention has been paid to the growing use of cyclosporin A in the treatment of RA as this drug represents the newest, most potent, nonexperimental form of treatment. The questions of when to introduce second‐line agents, who should receive treatment and how many drugs should be prescribed are all addressed in this review. The relative efficacy and toxicity of these agents is discussed and a treatment protocol is proposed.

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Prognostic value of early features in rheumatoid disease.

Cited by 90 publications

References 7 publications

Early rheumatoid arthritis —onset, course, and outcome over 2 years

Early rheumatoid arthritis —onset, course, and outcome over 2 years

Agalactosyl IgG: An aid to differential diagnosis in early synovitis

Therapeutic progress I: Current treatment of rheumatoid arthritis

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