TY - JOUR T1 - Characterization of Cumulative Joint Damage Patterns in Patients with Rheumatoid Arthritis: A Clinical, Serological, and Gene Polymorphism Perspective JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.131177 SP - jrheum.131177 AU - Renata Trigueirinho Alarcon AU - Artur da Rocha Corrêa Fernandes AU - Ieda Maria Magalhães Laurindo AU - Manoel Barros Bertolo AU - Geraldo da Rocha Castelar Pinheiro AU - Luís Eduardo Coelho Andrade Y1 - 2015/02/01 UR - http://www.jrheum.org/content/early/2015/01/27/jrheum.131177.abstract N2 - Objective To characterize cumulative joint damage (CJD) patterns in rheumatoid arthritis (RA) and determine their associations with demographic/clinical features and HLA-DRB1 gene polymorphism. Methods Hand and foot radiographs were obtained from 404 patients with RA. CJD patterns were determined by 3 derivations from Sharp/van der Heijde scores, obtained by the mathematical division of scores for hands/feet (Sharp-h/f score), fingers/wrists (Sharp-f/w score), and erosion/space narrowing (Sharp-e/sn score), respectively. DNA and serum were obtained for deter- mination of HLA-DRB1 polymorphism, rheumatoid factor (RF), and anticitrullinated protein antibodies (ACPA). Results Patients with wrist-dominant CJD pattern were more likely to have severe RA than those with finger-dominant pattern (68.4% vs 46.0%; p = 0.036) as were those with foot-dominant vs hand-dominant CJD pattern (76.5% vs 56.4%; p = 0.044). HLA-DRB1 shared epitope (SE) alleles were associated with erosion-dominant CJD pattern (p = 0.021). Patients with erosion-dominant CJD pattern had higher levels of RF and ACPA than those with space-narrowing–dominant CJD pattern (median RF 71.35 U/ml vs 22.05 U/ml, respectively; p = 0.003; median ACPA 187.9 U/ml vs 143.2 U/ml, respectively; p < 0.001). The majority of triple-positive patients (SE+, RF+, ACPA+) had erosion-dominant CJD pattern (62.3%) while the majority of triple-negative patients (SE–, FR–, ACPA–) had space narrowing–dominant CJD pattern (75%; p = 0.017). ACPA was associated with HLA-DRB1 SE alleles (p < 0.05). Patients with foot-dominant CJD pattern were taller than those with hand-dominant CJD pattern (p = 0.002); those with erosion-dominant CJD pattern had higher weight and body mass index than those with space narrowing–dominant CJD pattern (p = 0.014, p = 0.001). Conclusion CJD patterns were associated with disease severity, HLA-DRB1 SE status, presence and titer of ACPA and RF, and morphometric features. ER -