title: Clinical indicators of progression in psoriatic arthritis: multivariate relative risk model.
abstract: OBJECTIVE
  To identify markers for severe disease in psoriatic arthritis (PsA).
  
  
  METHODS
  Patients with PsA followed prospectively according to a standard protocol over 14 years were included. Clinical and laboratory assessments of both active inflammation and clinical damage were performed at 6-month intervals according to a standard protocol. The information was entered into a computer database. Progression in damage was defined as transitions between damage states based on the number of damaged joints. Both univariate and multivariate models were developed to identify predictors for progression of damage.
  
  
  RESULTS
  The best model available, based on patient characteristics at the time of being first seen in the psoriatic arthritis clinic suggests that a high number of effusions and of past medications predicts progression in damage, whereas a low sedimentation rate "protects" from such progression.
  
  
  CONCLUSIONS
  Evidence of significant inflammation at first visit predicts progression of damage in the future, suggesting that patients with PsA should be offered more aggressive treatment early in the course of their disease.
authors.affiliation: University of Toronto Rheumatic Disease Unit, Wellesley Hospital, Toronto, ON, Canada.
authors.forename: D D
authors.initials: DD
authors.lastname: Gladman
authors.forename: V T
authors.initials: VT
authors.lastname: Farewell
authors.forename: C
authors.initials: C
authors.lastname: Nadeau
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015535:Arthritis, Psoriatic / Q000453:epidemiology / Q000503:physiopathology*; D001799:Blood Sedimentation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors