Radiological damage in patients with rheumatoid arthritis on sustained remission. Issue 3 (25th August 2006)

• Record Type: Journal Article
• Authors: Cohen, G; Gossec, L; Dougados, M; Cantagrel, A; Goupille, P; Daures, JP; Rincheval, N; Combe, B
• Is Part Of: Annals of the rheumatic diseases. Volume 66:Issue 3(2007)
• Page Start: 358
• Page End: 363
• Publication Date: 2006-08-25
• Subjects: ACR, American College of Rheumatology -- CRP, C reactive protein -- DAS, Disease Activity Score -- DMARDs, disease-modifying antirheumatic drugs -- ESR, erythrocyte sedimentation rate -- HAQ, Health Assessment Questionnaire -- MRI, magnetic resonance imaging; Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/ard.2006.057497
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Objective: To assess the radiological damage progression in patients with recent rheumatoid arthritis in sustained remission. Methods: A cohort of 191 patients with active early (<1 year) rheumatoid arthritis was prospectively assessed at baseline, 3 and 5 years by the Disease Activity Score (DAS) and the Sharp–van der Heijde Score (SHS) for radiographic damage. Patients in remission (DAS<1.6) at the 3-year and 5-year time points were compared with patients with a persistently active rheumatoid arthritis by Wilcoxon's signed rank test. Results: 57 patients died, were lost to follow-up or had incomplete data; 30 (15.7% of those who completed) patients were in remission at 3 and 5 years. The SHS in these two groups was not significantly different at baseline (p = 0.15), but was lower in the remission group at 5 years (p = 0.0047). The median (IQR) radiographic score increased from 0.5 (0–7) at baseline to 2.5 (0–14) after 5 years for the remission group (p = 0.18) and from 2 (0–7) to 13 (3–29) in the group with active rheumatoid arthritis (p<0.001). 5 (16.7%) patients in remission had relevant progression of radiographic damage (ie, progression >4.1 points) and 6 (20%) presented new erosions in a previously unaffected joint between the third and the fifth years. Conclusion: Patients with early rheumatoid arthritis in sustained remission did not present statistically significant radiographic degradation at the group level; nevertheless, 16.7% of these patients did present degradation. Absence of progression should be part of the remission definition in rheumatoid arthritis.