Prediction of 20-year outcome at onset of seropositive rheumatoid arthritis.
OBJECTIVE
With the advent of new and expensive antirheumatic treatments with potentially serious side effects, it would be essential to identify as early as possible those rheumatoid arthritis (RA) patients who have a poor prognosis. Here study was made of the prognostic value of different markers recorded at the onset of RA.


METHODS
At the 20-year follow-up of our prospective study, 66 patients had rheumatoid factor-positive (RF+) RA. At commencement of follow-up (disease duration < 6 months), the prognostic value of 19 demographic, laboratory, clinical and radiographic variables was tested to explain the 20-year Larsen score for peripheral joints and the Health Assessment Questionnaire (HAQ) index using Somers'd for asymmetrical associations.


RESULTS
An association was observed between onset blood platelets (0.17), serum IgG (0.18), the onset Larsen score (0.33) and the 20-year Larsen score. Old age (0.30), serum orosomucoid (0.17), the function score (0.28), morning stiffness (0.28), and grip strength (0.24) were associated with the 20-year HAQ.


CONCLUSIONS
The correlation between the investigated entry variables and end-point outcome was poor. In our discussion we conclude that the most important prognostic factor in RF + RA is the treatment.
Jäntti
J K
JK
Rheumatism Foundation Hospital, Heinola, Finland.
Kaarela
K
K
Luukkainen
R K
RK
Kautiainen
H J
HJ
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000175:diagnosis* / Q000628:therapy*; D015415:Biomarkers; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012217:Rheumatoid Factor / Q000097:blood; D016896:Treatment Outcome
D015415:Biomarkers; D007074:Immunoglobulin G; D012217:Rheumatoid Factor