title: Predictors of severe radiographic progression in patients with early rheumatoid arthritis: A Prospective observational cohort study.
abstract: OBJECTIVE
  To identify predictors of severe radiographic progression in patients with early rheumatoid arthritis (ERA).
  
  
  METHODS
  A total of 374 patients with ERA were selected from a Korean prospective cohort. Based on their annual Sharp/Van der Heijde modified score changes (ΔSHS/year), patients were classified into severe and no progression groups. Predictors of severe progression were evaluated using a multivariable logistic regression.
  
  
  RESULTS
  After a mean follow-up duration of 4.2 years, the median (interquartile range) ΔSHS/year were 6.3 (4.4-10.2) and 0 (0-0) in the severe and no progression groups, respectively. Multivariable regression model revealed that Health Assessment Questionnaire (HAQ) score (odds ratio [OR] = 2.17), anticyclic citrullinated peptide antibody (OR = 3.44), body mass index (BMI; OR = 0.88), 6-month cumulative erythrocyte sedimentation rate (OR = 1.01) and baseline SHS (OR = 1.07) were independent predictors of severe progression. A model incorporating all five predictors satisfactorily predicted severe progression, with an area under the curve of 0.80. Baseline SHS was the predictor with the highest contribution to the predictive power of the final model (38%).
  
  
  CONCLUSIONS
  Our predictive model composed of five clinical predictors showed high discriminative ability between severe and no radiographic progression in patients with ERA. Among them, baseline SHS was the strongest predictor. Also, low BMI in Korean patients with ERA have a high risk of severe radiographic progression, as has previously been found for Caucasians.
authors.affiliation: Department of Rheumatology, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.
authors.forename: Young Bin
authors.initials: YB
authors.lastname: Joo
authors.affiliation: Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea.
authors.forename: So-Young
authors.initials: SY
authors.lastname: Bang
authors.affiliation: Department of Radiology, Hanyang University Hospital, Guri, Korea.
authors.forename: Jeong Ah
authors.initials: JA
authors.lastname: Ryu
authors.affiliation: Department of Radiology, Hanyang University Hospital, Seoul, Korea.
authors.forename: Seunghun
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea.
authors.forename: Hye-Soon
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea.
authors.forename: Sang-Cheol
authors.initials: SC
authors.lastname: Bae
mesh_terms: D000368:Aged; D000075422:Anti-Citrullinated Protein Antibodies / Q000097:blood; D019540:Area Under Curve; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000000981:diagnostic imaging* / Q000276:immunology; D001799:Blood Sedimentation; D015992:Body Mass Index; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D007596:Joints / Q000000981:diagnostic imaging*; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D056910:Republic of Korea; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D000075422:Anti-Citrullinated Protein Antibodies
keywords: body mass index; predictor; radiographic progression; rheumatoid arthritis; sharp score