ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2849

Radiographic Progression During a 10-Year Follow-Up : Results from the French Cohort ESPOIR

Joanna Kedra1, David Hajage 2, Alexandre Lafourcade 2, Bernard Combe 3, Maxime Dougados 4 and Bruno Fautrel 5, 1Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), UMR S1136, Paris France, Paris, France, 2Biostatistics, Public Health and Medical Information department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France, Paris, France, 3CHU Montpellier, Montpellier University, Montpellier, France, 4Cochin Hospital, Paris, France, 5Pitié-Salpêtrière Hospital, Department of Rheumatology, AP-HP, Sorbonne University, UPMC university, Paris, Ile-de-France, France

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: ,

Session Information

Date: Tuesday, November 12, 2019

Title: 5T114: RA – Diagnosis, Manifestations, & Outcomes IV: Outcomes (2846–2851)

Session Type: ACR Abstract Session

Session Time: 4:30PM-6:00PM

Background/Purpose: In early arthritis, identification of patients at risk of developing joint damage is an important issue. In rheumatoid arthritis (RA), the rate of progression is highest during the first 2 years and most of the damage occurs within the first 5 years.

The aim of this study was to describe the patterns of radiographic progression during a 10-year follow-up in the French cohort ESPOIR.

Methods: In this national multicenter cohort, 813 adult patients with suspected or confirmed early RA were included between December 2002 and March 2005, and followed up during 10 years. Radiographs were obtained and modified Sharp scores (vSHS) were determined by a blinded reader. The primary outcome was radiographic progression (RP) at 10 years, defined as a significant increase of vSHS (smallest detectable difference ⩾11). Secondary outcomes were rapid radiographic progression (RRP), defined as >5-point annual increase in vSHS, and non-progression (NP), defined as < 1-point increase in vSHS at the end of the follow-up. Quantitative variables were described by mean ± SD and qualitative variables by number and percentage. The patient groups were compared using Fisher exact test for qualitative variables and Mann-Whitney test for quantitative variables. P values ≤ 0.05 were considered statistically significant.

Results: Overall, 400 patients (49.2%) had complete data at the end of the follow-up; among them, 343 patients fulfilled ACR-EULAR 2010 criteria at baseline. Radiographs scoring was available for M0, M24, M60, M84 and M120.

The mean progression was of 10.9 (SD=17.9) during the 10-year follow-up, and was significantly higher in patients fulfilling ACR-EULAR 2010 criteria compared with those who weren’t (11.9 (SD=18.5) and 5.9 (SD=12.4) respectively, p=0.002). Progression was more important during the 5 first years (Figure 1). The mean progression on erosion score was of 4.0 (SD=8.4) and the mean progression on joint space narrowing score was of 6.9 (SD=10.7).

At the end of the follow-up, 93 patients (23.3%) experienced RP, 16 of whom (4.0%) experienced RRP, 227 patients (56.7%) progressed below the smallest detectable change, and 80 patients (20.0%) did not progress, 8 of whom (2.0%) had an improvement in their vSHS. There was a significant difference in terms of RP between patients fulfilling or not ACR-EULAR 2010 criteria (N=86 (21.6%) and N=7 (10.8%) respectively, p=0.03), but there was no difference for RRP (N=15 (3.8%) and N=1 (1.5%) respectively, p=0.49) and NP (N=63 (15.8%) and N=13 (20%) respectively, p=0.10).

Conclusion: Overall, about 20% of the patients experienced RP at the end of the 10-year follow-up, with significantly more progressors among patients fulfilling ACR-EULAR 2010 criteria. Predictors of RP are currently investigated.

Figure 1: mean radiographic progression during the 10-year follow-up -black: overall population; red: patients fulfilling ACR-EULAR 2010 criteria at baseline; blue: patients not fulfilling ACR-EULAR 2010 criteria at baseline-

Disclosure: J. Kedra, None; D. Hajage, None; A. Lafourcade, None; B. Combe, AbbVie, 5, BMS, 5, 8, Chugai, 5, 8, Eli Lilly, 5, Eli Lilly and Company, 5, 8, Gilead, 5, 8, Gilead Sciences, Inc., 5, 8, Janssen, 5, Lilly, 5, 8, MSD, 2, 5, 8, Novartis, 5, Pfizer, 2, 5, 8, Roche, 2, 5, 8, Roche-Chugai, 5, 8, Sanofi, 5, UCB, 5, USD, 5; M. Dougados, AbbVie, 2, 5, 8, Amgen, 5, Biogen, 5, BMS, 2, 5, 8, Eli Lilly, 2, 5, 8, Gilead, 2, 5, Janssen, 2, 5, Merck, 2, 5, Merck Inc, 2, 5, Novartis, 2, 5, 8, Pfizer, 2, 5, 8, Pfizer Inc, 2, 5, Roche, 2, 5, 8, UCB, 2, 5, 8; B. Fautrel, AbbVie, 2, 5, 8, Biogen, 5, 8, BMS, 5, 8, Boehringer Ingelheim, 8, Celgene, 5, 8, Eli Lilly and Company, 2, 5, Janssen, 5, 8, Lilly, 8, Medac, 5, 8, MSD, 2, 5, 8, NORDIC Pharma, 5, 8, Novartis, 5, 8, Pfizer, 2, 5, 8, Roche, 5, 8, Sanofi-Aventis, 5, SOBI, 5, 8, UCB, 5, 8.

To cite this abstract in AMA style:

Kedra J, Hajage D, Lafourcade A, Combe B, Dougados M, Fautrel B. Radiographic Progression During a 10-Year Follow-Up : Results from the French Cohort ESPOIR [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/radiographic-progression-during-a-10-year-follow-up-results-from-the-french-cohort-espoir/. Accessed .

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