Patients with seronegative RA have more inflammatory activity compared with patients with seropositive RA in an inception cohort of DMARD-naïve patients classified according to the 2010 ACR/EULAR criteria. Issue 2 (19th April 2016)

• Record Type: Journal Article
• Authors: Nordberg, Lena Bugge; Lillegraven, Siri; Lie, Elisabeth; Aga, Anna-Birgitte; Olsen, Inge Christoffer; Hammer, Hilde Berner; Uhlig, Till; Jonsson, Maria Karolina; van der Heijde, Désirée; Kvien, Tore K; Haavardsholm, Espen Andre
• Other Names: author non-byline.; Fremstad Hallvard author non-byline.; Madland Tor Magne author non-byline.; Lexberg Åse Stavland author non-byline.; Haukeland Hilde author non-byline.; Rødevand Erik author non-byline.; Høili Christian author non-byline.; Stray Hilde author non-byline.; Bendvold Anne Noraas author non-byline.; Soldal Dag Magnar author non-byline.; Bakland Gunnstein author non-byline.
• Is Part Of: Annals of the rheumatic diseases. Volume 76:Issue 2(2017)
• Page Start: 341
• Page End: 345
• Publication Date: 2016-04-19
• Subjects: Rheumatoid Arthritis -- Ant-CCP -- Rheumatoid Factor -- Early Rheumatoid Arthritis; Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2015-208873
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Objectives: To compare the presentation of seropositive and seronegative early rheumatoid arthritis (RA) in disease-modifying antirheumatic drug (DMARD)-naïve patients classified according to the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) criteria. Methods: All patients had symptom duration from first swollen joint <2 years and were DMARD naïve with an indication for DMARD treatment. Patients were stratified as seropositive (positive rheumatoid factor (RF)+ and/or anticitrullinated peptide antibody (ACPA)+) or seronegative (RF− and ACPA−), and disease characteristics were compared between groups. Results: A total of 234 patients were included, and 36 (15.4%) were seronegative. Ultrasonography (US) scores for joints (median 55 vs 25, p<0.001) and tendons (median 3 vs 0, p<0.001), number of swollen joints (median 17 vs 8, p<0.001), disease activity score (DAS; mean 3.9 vs 3.4, p=0.03) and physician global assessment (mean 49.1 vs 38.9, p=0.006) were significantly higher in seronegative patients compared with seropositive. Total van der Heijde-modified Sharp score, Richie Articular Index and patient-reported outcome measures were similar between groups. Conclusions: Seronegative patients had higher levels of inflammation, assessed both clinically and by US, than seropositive patients. These differences may reflect the high number of involved joints required for seronegative patients to fulfil the 2010 ACR/EULAR classification criteria for RA. Trial registration number: NCT01205854; Pre-results.