title: Health assessment questionnaire-disability index (HAQ-DI) score at the start of biological disease-modifying antirheumatic drug (bDMARD) therapy is associated with radiographic progression of large joint damage in patients with rheumatoid arthritis.
abstract: OBJECTIVE
  Radiographic progression of damage (RPD) to large joints in patients with rheumatoid arthritis (RA) has not been fully studied. We previously demonstrated that Larsen grade of the large joints was associated with RPD of large joints in patients treated with biological disease-modifying anti-rheumatic drugs (bDMARDs); however, no factors associated with background characteristics of patients were identified.
  
  
  METHODS
  A total of 400 large joints in the upper and lower extremities, including the shoulder, elbow, knee, and ankle, of 88 patients with RA treated with bDMARDs for 1-3 years were investigated. Radiographs of tender and/or swollen large joints were acquired at least twice during the study period (mean, 16.4 months), and the RPD was evaluated.
  
  
  RESULTS
  A multivariate analysis revealed that health assessment questionnaire-disability index (HAQ-DI) score at the start of bDMARD treatment was associated with RPD. The cutoff value that discriminated progression from non-progression, determined by a receiver operating characteristic (ROC) curve, was 1.4375 (sensitivity: 0.778, specificity: 0.894).
  
  
  CONCLUSIONS
  HAQ-DI score at the start of bDMARD treatment was associated with RPD to large joints during a therapeutic period of 1-3 years. Progressive damage is expected to increase when functional disability exceeds an HAQ-DI score of 1.5.
authors.affiliation: a Departments of Orthopaedics , Toho University Sakura Medical Center , Chiba , Japan.|b Departments of Rheumatology , Toho University Sakura Medical Center , Chiba , Japan.
authors.forename: Arata
authors.initials: A
authors.lastname: Nakajima
authors.affiliation: c Department of General Medical Sciences, Graduate School of Medicine , Chiba University , Chiba , Japan.|d Department of Orthopaedic Surgery , Eastern Chiba Medical Center , Chiba , Japan.
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Aoki
authors.affiliation: e Departments of Rehabilitation , Toho University Sakura Medical Center , Chiba , Japan.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Terayama
authors.affiliation: a Departments of Orthopaedics , Toho University Sakura Medical Center , Chiba , Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Sonobe
authors.affiliation: a Departments of Orthopaedics , Toho University Sakura Medical Center , Chiba , Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takahashi
authors.affiliation: a Departments of Orthopaedics , Toho University Sakura Medical Center , Chiba , Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Saito
authors.affiliation: a Departments of Orthopaedics , Toho University Sakura Medical Center , Chiba , Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Nakagawa
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D004185:Disability Evaluation; D018450:Disease Progression; D007596:Joints / Q000000981:diagnostic imaging / Q000473:pathology; D011859:Radiography; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D018501:Antirheumatic Agents
keywords: Health assessment questionnaire-disability index (HAQ-DI) score; biological disease-modifying antirheumatic drugs (bDMARDs); large joints; radiographic progression of damage; rheumatoid arthritis