Session Information
Title: Rheumatoid Arthritis - Clinical Aspects I: Risk Factors and Prediction of Rheumatoid Arthritis
Session Type: Abstract Submissions (ACR)
Background/Purpose: The potential of the 2010 ACR/EULAR rheumatoid arthritis (RA) classification criteria to discriminate early arthritis patients according to their clinical and radiological outcomes needs to be confirmed. Methods: Consecutive patients with at least 3 swollen joints (SJC≥ 3) were recruited; duration of disease was more than 1 and less than 12 months; microcrystalline arthritides and connective tissue diseases were actively excluded. All patients were treated with the target of SJC= 0, using whatever DMARDs was required. According to the 2010 RA criteria, our cohort was classified in two groups: RA and non-specific inflammatory arthritis (NSIA). Both groups were compared at baseline and at 18 months into disease according to radiological and clinical outcomes: Sharp erosion score (classified erosive if ≥ 3), Health Assessment Questionnaire (HAQ), Disease Activity Score in 28 joints (DAS28-CRP), and pain (0-100 mm VAS). Remission rates at 18 months were calculated based on DAS 28 and ACR 2011 remission criteria. Results: A total of 422 patients were available at baseline. Of these, 319 (75.6%) were classified as RA. Based on clinical outcome measures, RA patients had more severe disease than NSA patients at baseline (higher DAS 28, HAQ and pain scores measures – p<0.001). At 18 months, this initial clinical discrepancy had now disappeared, but more RA patients had progressed to erosive status than NSIA patients (54% vs 33%; p<0.001). Using two different definitions of remission, there was no difference in remission rates. Conclusion: In this early arthritis cohort actively treated to SJC= 0, there was no difference in the 18-month clinical outcomes (HAQ, DAS 28, Pain, Remission rates) between 2010 ACR/EULAR criteria-defined RA and NSIA patients. Patients with RA had a worse radiological outcome, but significant joint damage occurred in one third of NSIA patients. Early intensive treatment of NSIA patients, and not only of early RA patients, thus appears warranted.
|
Rheumatoid arthritis (2010 ACR/EULAR criteria) mean (median) |
Non specific inflammatory arthritis mean (median) |
P value
|
Baseline |
|||
HAQ |
0.95 (0.875) |
0.625 (0.5) |
P <0.001 |
DAS 28 – CRP |
5.53 (5.58) |
4.61 (4.57) |
P<0.001 |
Pain |
59.2 (61) |
47.3 (47) |
P<0.001 |
18 months |
|||
HAQ |
0.38 (0.25) |
0.38 (0.125) |
P=0.717 |
DAS 28 – CRP |
2.47 (2.84) |
2.64 (2.33) |
P=0.238 |
Pain |
29.0 (24) |
31.4 (23) |
P=0.485 |
Sharp erosion score |
5.67 (3.0) |
3.14 (1.0) |
P=0.002 |
Remission at 18 months |
|||
DAS 28 – CRP |
53% |
58.6% |
P =0.316 |
ACR 2011 |
16% |
18.8% |
P=0.964 |
Disclosure:
A. Masetto,
None;
A. J. Fernandes,
None;
P. Liang,
None;
P. Cossette,
None;
G. Boire,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/2010-acreular-rheumatoid-arthritis-classification-criteria-predicts-radiogical-but-not-clinical-outcomes-at-18-months-into-disease-in-a-canadian-early-arthritis-cohort/