title: Rheumatoid Factor Is Associated With the Distribution of Hand Joint Destruction in Rheumatoid Arthritis.
abstract: OBJECTIVE
  Rheumatoid arthritis (RA) is a chronic disease leading to joint destruction. Although many studies have addressed factors potentially correlated with the speed of joint destruction, less attention has been paid to the distribution of joint destruction in patients with RA. In this study, destruction of the hand bones in patients with RA was classified into 2 anatomic subgroups, the fingers and the non-fingers, with the aim of analyzing which factors are associated with destruction of the finger joints.
  
  
  METHODS
  A total of 1,215 Japanese patients with RA were recruited from 2 different populations. The degree of joint destruction was assessed using the total modified Sharp/van der Heijde score (SHS) of radiographic joint damage. The SHS score of joint damage in the finger joints was used as the dependent variable, and the SHS score in the non-finger joints was used as a covariate. Age, sex, disease duration, smoking, C-reactive protein level, treatment for RA, and positivity for and levels of anti-citrullinated protein antibodies and rheumatoid factor (RF) were evaluated as candidate correlates. Overall effect sizes were assessed in a meta-analysis. In addition, associations observed in the Japanese patients were compared to those in a cohort of 157 Dutch RA patients in the BeSt study (a randomized, controlled trial involving 4 different strictly specified treatment strategies for early RA).
  
  
  RESULTS
  Not surprisingly, disease duration in Japanese patients with RA was associated with the finger SHS score (P ≤ 0.00037). Both positivity for and levels of RF showed significant associations with the finger SHS score after adjustment for covariates (P = 0.0022 and P = 8.1 × 10(-7) , respectively). These associations were also true in relation to the time-averaged finger SHS score. An association between RF positivity and the finger SHS score was also observed in Dutch patients with RA in the BeSt study (P = 0.049).
  
  
  CONCLUSIONS
  Positivity for and levels of RF are associated with finger joint destruction independent of non-finger joint destruction and other covariates. Our findings suggest that there are different mechanisms of joint destruction operating in the finger joints of patients with RA.
authors.affiliation: Kyoto University Graduate School of Medicine, Kyoto, Japan, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, and Broad Institute, Cambridge, Massachusetts.
authors.forename: Chikashi
authors.initials: C
authors.lastname: Terao
authors.affiliation: Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Yamakawa
authors.affiliation: Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yano
authors.affiliation: Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Iris M
authors.initials: IM
authors.lastname: Markusse
authors.affiliation: Tokyo Women's Medical University and CREST Program, Japan Science and Technology Agency, Tokyo, Japan.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Ikari
authors.affiliation: Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Yoshida
authors.affiliation: Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Moritoshi
authors.initials: M
authors.lastname: Furu
authors.affiliation: Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Motomu
authors.initials: M
authors.lastname: Hashimoto
authors.affiliation: Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Hiromu
authors.initials: H
authors.lastname: Ito
authors.affiliation: Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Fujii
authors.affiliation: Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Ohmura
authors.affiliation: Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Kosaku
authors.initials: K
authors.lastname: Murakami
authors.affiliation: Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Meiko
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
authors.forename: Masahide
authors.initials: M
authors.lastname: Hamaguchi
authors.affiliation: Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Tabara
authors.affiliation: Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Atsuo
authors.initials: A
authors.lastname: Taniguchi
authors.affiliation: Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Momohara
authors.affiliation: Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, Broad Institute, Cambridge, Massachusetts, and University of Manchester and Manchester Academic Health Sciences Centre, Manchester, UK.
authors.forename: Soumya
authors.initials: S
authors.lastname: Raychaudhuri
authors.affiliation: Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Cornelia F
authors.initials: CF
authors.lastname: Allaart
authors.affiliation: Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Yamanaka
authors.affiliation: Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Tsuneyo
authors.initials: T
authors.lastname: Mimori
authors.affiliation: Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Matsuda
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000235:genetics / Q000276:immunology*; D044466:Asian People; D001323:Autoantibodies / Q000276:immunology; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging*; D033023:Foot Joints / Q000000981:diagnostic imaging; D059811:HLA-DRB1 Chains / Q000235:genetics; D050823:Hand Joints / Q000000981:diagnostic imaging; D006801:Humans; D007564:Japan; D016014:Linear Models; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D009426:Netherlands; D010456:Peptides, Cyclic / Q000276:immunology; D011859:Radiography; D012217:Rheumatoid Factor / Q000276:immunology*; D012720:Severity of Illness Index; D044465:White People
chemical_list: D018501:Antirheumatic Agents; D001323:Autoantibodies; D059811:HLA-DRB1 Chains; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide; D012217:Rheumatoid Factor; D008727:Methotrexate