title: Repair of joint erosions in rheumatoid arthritis: prevalence and patient characteristics in a large inception cohort.
abstract: BACKGROUND
  Joint destruction in rheumatoid arthritis (RA) was until recently seen as an irreversible state. Lately, it was found that repair of bone erosions occurs; however, little is known about its prevalence.
  
  
  OBJECTIVE
  To investigate the frequency of repair and patients' characteristics associated with repair in an inception cohort.
  
  
  METHODS
  250 patients with RA, included in the Leiden Early Arthritis Clinic between 1993 and 2000 and treated with conventional disease-modifying antirheumatic drugs, were studied (mean follow-up 10.1 years). Radiographs obtained annually were scored using the Sharp-van der Heijde method, initially aware of the chronology. Patients with a negative change in erosion scores on subsequent radiographs were selected and their series of radiographs were re-scored with concealed time sequence by three readers. Repair was defined as agreement between two readers of a negative change in erosion scores that persisted for at least 2 years.
  
  
  RESULTS
  Repair was identified in 32 joints in 18 patients (7.2%). Patients with repair had a greater prevalence of autoantibodies (rheumatoid arthritis, anti-citrullinated protein antibody) and a higher level of joint destruction. In the joints with repair, arthritis was absent in the 2 years preceding repair.
  
  
  CONCLUSIONS
  Repair occurred in 7.2% of the patients with RA, particularly in clinically inactive joints in patients with severe destructive disease.
authors.affiliation: Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands. M.P.M.van_der_Linden@lumc.nl
authors.forename: Michael P M
authors.initials: MP
authors.lastname: van der Linden
authors.forename: Ramona
authors.initials: R
authors.lastname: Boja
authors.forename: Naomi B
authors.initials: NB
authors.lastname: Klarenbeek
authors.forename: Tom W J
authors.initials: TW
authors.lastname: Huizinga
authors.forename: Désirée M
authors.initials: DM
authors.lastname: van der Heijde
authors.forename: Annette H M
authors.initials: AH
authors.lastname: van der Helm-van Mil
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology*; D001323:Autoantibodies / Q000032:analysis; D001861:Bone Regeneration / Q000502:physiology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012074:Remission Induction; D012720:Severity of Illness Index
chemical_list: D018501:Antirheumatic Agents; D001323:Autoantibodies