title: Rapid radiological progression in the first year of early rheumatoid arthritis is predictive of disability and joint damage progression during 8 years of follow-up.
abstract: OBJECTIVE
  Several prediction models for rapid radiological progression (RRP) in the first year of rheumatoid arthritis have been designed to aid rheumatologists in their choice of initial treatment. The association was assessed between RRP and disability and joint damage progression in 8 years.
  
  
  METHODS
  Patients from the BeSt cohort were used. RRP was defined as an increase of ≥5 points in the Sharp/van der Heijde score (SHS) in year 1. Functional ability over 8 years, measured with the health assessment questionnaire (HAQ), was compared for patients with and without RRP using linear mixed models. Joint damage progression from years 1 to 8 was compared using logistic regression analyses.
  
  
  RESULTS
  RRP was observed in 102/465 patients. Over 8 years, patients with RRP had worse functional ability: difference in HAQ score 0.21 (0.14 after adjustment for disease activity score (over time)). RRP was associated with joint damage progression ≥25 points in SHS in years 1-8: OR 4.6.
  
  
  CONCLUSIONS
  RRP in year 1 is a predictor of worse functional ability over 8 years, independent of baseline joint damage and disease activity. Patients with RRP have more joint damage progression in subsequent years. RRP is thus a relevant outcome on which to base the initial treatment decision.
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. m.van_den_broek@lumc.nl
authors.forename: M
authors.initials: M
authors.lastname: van den Broek
authors.forename: L
authors.initials: L
authors.lastname: Dirven
authors.forename: J K
authors.initials: JK
authors.lastname: de Vries-Bouwstra
authors.forename: A J
authors.initials: AJ
authors.lastname: Dehpoor
authors.forename: Y P M
authors.initials: YP
authors.lastname: Goekoop-Ruiterman
authors.forename: A H
authors.initials: AH
authors.lastname: Gerards
authors.forename: P J S M
authors.initials: PJ
authors.lastname: Kerstens
authors.forename: T W J
authors.initials: TW
authors.lastname: Huizinga
authors.forename: Wf
authors.initials: W
authors.lastname: Lems
authors.forename: C F
authors.initials: CF
authors.lastname: Allaart
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D007596:Joints / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011859:Radiography