title: Predictors of radiological progression and changes in hand bone density in early rheumatoid arthritis.
abstract: OBJECTIVE
  To identify predictors for radiological and functional outcome and bone loss in the hands in early rheumatoid arthritis (RA) during the first 2 yr of disease and to study the relationship between these variables.
  
  
  METHODS
  An inception cohort of consecutively recruited patients was examined at baseline and after 12 and 24 months using X-rays of hands and feet, clinical [28-joint count, Health Assessment Questionnaire (HAQ), global visual analogue scale (VAS), grip strength] and laboratory (erythrocyte sedimentation rate, C-reactive protein, markers of bone formation and resorption) measurements and dual-energy X-ray absorptiometry measurements of the hands.
  
  
  RESULTS
  Joint destruction increased significantly during the study, with the Larsen score at baseline as the strongest predictor. Radiological progression and bone loss over 24 months were significantly retarded in patients responding to therapy. The effects of the shared epitope and initial high inflammatory activity on radiological progression were overridden by the therapeutic response. Radiological progression correlated significantly with bone loss. Global VAS, Larsen score and HAQ at inclusion significantly predicted change in HAQ over time.
  
  
  CONCLUSIONS
  Radiological progression and bone loss were retarded by early therapeutic response. Bone loss was related to radiological progression.
authors.affiliation: Department of Rheumatology, University Hospital, Umeå, Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Berglin
authors.forename: R
authors.initials: R
authors.lastname: Lorentzon
authors.forename: L
authors.initials: L
authors.lastname: Nordmark
authors.forename: B
authors.initials: B
authors.lastname: Nilsson-Sojka
authors.forename: S
authors.initials: S
authors.lastname: Rantapää Dahlqvist
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006225:Hand / Q000503:physiopathology*; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers