title: Clinical predictors of erosion-free status in rheumatoid arthritis: a prospective cohort study.
abstract: OBJECTIVE
  Treatment algorithms in RA include factors associated with poor prognosis; however, many patients remain erosion free despite years of disease. Our objective was to characterize the group of RA patients without erosions and identify its clinical predictors.
  
  
  METHODS
  Our study was conducted within a prospective observational cohort of RA patients recruited from the outpatient practice of an academic medical centre. We studied patients with bilateral hand radiographs at cohort baseline and 2-year follow-up assessed with Sharp/van der Heijde scores (SHS). The primary outcome was erosion-free status at baseline and 2-year follow-up. We assessed baseline values of the following as potential correlates: age at RA onset, gender, RA duration, BMI, 28-joint DAS (DAS-28), CRP, anti-CCP status, tender and swollen joint counts, functional status [multidimensional HAQ (MDHAQ)], tobacco use and RA treatments. Variables with P ≤ 0.25 in the univariate analyses were assessed using backward selection in multivariable logistic regression models.
  
  
  RESULTS
  Of the 271 subjects included, 21% (n = 56) were considered erosion free. Forty-six per cent (n = 26) of this group was anti-CCP positive compared with 56% (n = 121) in subjects with erosions present. Mean RA duration for erosion-free subjects was 3.9 years compared with 4.6 years in erosive subjects. Treatments for RA did not differ between the two groups. In the multivariable-adjusted analysis, significant predictors of erosion-free status were younger age at onset and shorter RA duration.
  
  
  CONCLUSIONS
  In our cohort, 21% of subjects were erosion free at baseline and 2 years. Few baseline clinical characteristics significantly predicted erosion-free status.
authors: Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA 02115, USA. kliao@partners.org
authors: Katherine P
authors: KP
authors: Liao
authors: Michael E
authors: ME
authors: Weinblatt
authors: Jing
authors: J
authors: Cui
authors: Christine
authors: C
authors: Iannaccone
authors: Lori B
authors: LB
authors: Chibnik
authors: Bing
authors: B
authors: Lu
authors: Jonathan S
authors: JS
authors: Coblyn
authors: Nancy A
authors: NA
authors: Shadick
authors: Daniel H
authors: DH
authors: Solomon
mesh_terms: D001172:Arthritis, Rheumatoid / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D001175:Arthrography; D001323:Autoantibodies / Q000097:blood; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D050823:Hand Joints / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000276:immunology; D011379:Prognosis; D011446:Prospective Studies; D012217:Rheumatoid Factor / Q000097:blood
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide; D012217:Rheumatoid Factor