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.
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 October 6, 2022.
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