title: Relationship between disease activity indices and their individual components and radiographic progression in RA: a systematic literature review.
abstract: OBJECTIVE
  The aim of this study was to investigate the relationship between different disease activity indices (DAIs) and their individual components and radiographic progression in patients with RA.
  
  
  METHODS
  A systematic literature review until July 2013 was performed by two independent reviewers using the Medline and Embase databases. Longitudinal studies assessing the relationship between DAIs and single instruments and radiographic progression were included. The results were grouped based on the means of measurement (baseline vs time integrated) and analysis (univariable or multivariable).
  
  
  RESULTS
  Fifty-seven studies from 1232 hits were included. All published studies that assessed the relationship between any time-integrated DAI including joint count and radiographic progression reached a statistically significant association. Among the single instruments, only swollen joint count and ESR were associated with radiographic progression, while no significant association was found for tender joint count. Data with respect to CRP are conflicting. Data on patient's global health, pain assessment and evaluator's global assessment are limited and do not support a positive association with progression of joint damage.
  
  
  CONCLUSIONS
  Published data indicate that all DAIs that include swollen joints are related to radiographic progression while, of the individual components, only swollen joints and acute phase reactants are associated. Therefore composite DAIs are the optimal tool to monitor disease activity in patients with RA.
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands, Department of Rheumatology, University Hospital La Paz, Madrid, Spain, Department of Rheumatology and Internal Medicine, Cantacuzino Clinical Hospital, Bucharest, Romania, Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Second Department of Medicine, Hietzing Hospital, Vienna, Austria and Amsterdam Rheumatology Center, Amsterdam, and Atrium Medical Center, Heerlen, The Netherlands Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands, Department of Rheumatology, University Hospital La Paz, Madrid, Spain, Department of Rheumatology and Internal Medicine, Cantacuzino Clinical Hospital, Bucharest, Romania, Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Second Department of Medicine, Hietzing Hospital, Vienna, Austria and Amsterdam Rheumatology Center, Amsterdam, and Atrium Medical Center, Heerlen, The Netherlands mvictoria.navarroc@gmail.com.
authors.forename: Victoria
authors.initials: V
authors.lastname: Navarro-Compán
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands, Department of Rheumatology, University Hospital La Paz, Madrid, Spain, Department of Rheumatology and Internal Medicine, Cantacuzino Clinical Hospital, Bucharest, Romania, Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Second Department of Medicine, Hietzing Hospital, Vienna, Austria and Amsterdam Rheumatology Center, Amsterdam, and Atrium Medical Center, Heerlen, The Netherlands Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands, Department of Rheumatology, University Hospital La Paz, Madrid, Spain, Department of Rheumatology and Internal Medicine, Cantacuzino Clinical Hospital, Bucharest, Romania, Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Second Department of Medicine, Hietzing Hospital, Vienna, Austria and Amsterdam Rheumatology Center, Amsterdam, and Atrium Medical Center, Heerlen, The Netherlands.
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Gherghe
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands, Department of Rheumatology, University Hospital La Paz, Madrid, Spain, Department of Rheumatology and Internal Medicine, Cantacuzino Clinical Hospital, Bucharest, Romania, Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Second Department of Medicine, Hietzing Hospital, Vienna, Austria and Amsterdam Rheumatology Center, Amsterdam, and Atrium Medical Center, Heerlen, The Netherlands Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands, Department of Rheumatology, University Hospital La Paz, Madrid, Spain, Department of Rheumatology and Internal Medicine, Cantacuzino Clinical Hospital, Bucharest, Romania, Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Second Department of Medicine, Hietzing Hospital, Vienna, Austria and Amsterdam Rheumatology Center, Amsterdam, and Atrium Medical Center, Heerlen, The Netherlands.
authors.forename: Josef S
authors.initials: JS
authors.lastname: Smolen
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands, Department of Rheumatology, University Hospital La Paz, Madrid, Spain, Department of Rheumatology and Internal Medicine, Cantacuzino Clinical Hospital, Bucharest, Romania, Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Second Department of Medicine, Hietzing Hospital, Vienna, Austria and Amsterdam Rheumatology Center, Amsterdam, and Atrium Medical Center, Heerlen, The Netherlands.
authors.forename: Daniel
authors.initials: D
authors.lastname: Aletaha
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands, Department of Rheumatology, University Hospital La Paz, Madrid, Spain, Department of Rheumatology and Internal Medicine, Cantacuzino Clinical Hospital, Bucharest, Romania, Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Second Department of Medicine, Hietzing Hospital, Vienna, Austria and Amsterdam Rheumatology Center, Amsterdam, and Atrium Medical Center, Heerlen, The Netherlands.
authors.forename: Robert
authors.initials: R
authors.lastname: Landewé
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands, Department of Rheumatology, University Hospital La Paz, Madrid, Spain, Department of Rheumatology and Internal Medicine, Cantacuzino Clinical Hospital, Bucharest, Romania, Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Second Department of Medicine, Hietzing Hospital, Vienna, Austria and Amsterdam Rheumatology Center, Amsterdam, and Atrium Medical Center, Heerlen, The Netherlands.
authors.forename: Désirée
authors.initials: D
authors.lastname: van der Heijde
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D007596:Joints / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012720:Severity of Illness Index
keywords: RA; disease activity; instrument; outcome; radiographic progression; score