Session Title: Rheumatoid Arthritis-Clinical Aspects III: Outcome Measures, Socioeconomy, Screening, Biomarkers in Rheumatoid Arthritis
Session Type: Abstract Submissions (ACR)
Background/Purpose: A EULAR task force has recently selected an evidence and consensus based definition of erosive disease defining rheumatoid arthritis (RA) in patients who do otherwise not fulfil the 2010 ACR/EULAR criteria for classification of the disease. Erosive disease was defined as a minimum of 3 erosions in particular joints.
Methods: For this observational cohort study within the RA cohort of the Swiss registry SCQM, we included patients suffering from early RA or undifferentiated arthritis (disease duration ≤1 year), as defined by the treating rheumatologist, who had not received any previous DMARDs. Baseline diagnosis of RA/UA was reassessed according to the 2010 ACR/EULAR criteria at baseline. 2010 ACR/EULAR criteria negative patients were separated into 2 groups depending on whether or not they had more than two erosions in the Ratingen score (Ratingen positive: >2; Ratingen negative <3). The primary outcome measures were the radiological progression. HAQ and DAS 28 were used as secondary outcome measures. The average observation period was 4 years.
Results: A total number of 592 patients was analysed. 240 were not classifiable as RA according to the new criteria at baseline. 133 patients were Ratingen positive and 50 patients were Ratingen negative, 57 patients were not classifiable. Treatment was initiated in all patients with DMARDs, mostly MTX. There were no significant differences in the therapeutic strategies between Ratingen positive and negative patients. No differences in DAS 28 and HAQ scores were found during follow up over 4 years. Average radiographic progression was higher among Ratingen positive as compared to Ratingen negative patients (6.6 erosions/year vs. 0.4, resp., p=0.0004).
Conclusion: The presence of more than 2 erosions in the Ratingen score selected RA patients not fulfilling the 2010 ACR/EULAR criteria who will suffer from a radiographic progressive disease. This indicates that the propose definition of erosive disease is, indeed, selecting patients, who will develop definite RA.
J. von Kempis,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/does-a-ratingen-score-of-%e2%89%a5-3-at-disease-onset-define-ra-in-acreular-2010-criteria-negative-patients/