Radiological progression of joint damage in a longitudinal cohort of early DMARD-treated rheumatoid arthritis patients followed for 10 years.
OBJECTIVE
The efficacy of DMARD therapy in rheumatoid arthritis (RA) can be judged by radiological analysis. This study aimed to determine the time-dependent progression of joint damage, acute-phase response, and rates of radiologic progression in early DMARD-treated RA patients over 10 years.


METHODS
We evaluated outpatient records, and radiographs of hands and feet of 54 early RA patients on DMARDs for 10 years. Radiographs were quantified by the Larsen method using recently developed quantification software.


RESULTS
Radiological damage attenuated, with disease progression from baseline to Year 10 [correlation coefficient (r)=0.95, probability (p)<0.001]. Radiographic scores progressed more rapidly during the first 5 years than thereafter. Cumulative erythrocyte sedimentation rate (ESR) was strongly correlated with radiological progression (p<0.001, r=0.88).


CONCLUSIONS
Our findings reveal a higher amount of radiographic RA progression during the first years of DMARD treatment. Thus, our data provide strong evidence for the importance of both early DMARD therapy and continuous radiographic assessments in RA.
Wick
M C
MC
Rheumatology Unit, Department of Medicine at Karolinska Hospital, Stockholm, Sweden. marius.wick@ks.se
Anderwald
C
C
Weiss
R J
RJ
Imhof
H
H
Kainberger
F
F
Smolen
J S
JS
D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy* / Q000473:pathology*; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012016:Reference Values
D018501:Antirheumatic Agents