RT Journal Article
SR Electronic
T1 Clinical Activity After 12 Weeks of Treatment with Nonbiologics in Early Rheumatoid Arthritis May Predict Articular Destruction 2 Years Later
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 723
OP 729
DO 10.3899/jrheum.090776
VO 37
IS 4
A1 YOICHI ICHIKAWA
A1 TERUNOBU SAITO
A1 HISASI YAMANAKA
A1 MASASHI AKIZUKI
A1 HIROBUMI KONDO
A1 SHIGETO KOBAYASHI
A1 HISAJI OSHIMA
A1 SHINICHI KAWAI
A1 NOBUAKI HAMA
A1 HIDEHIRO YAMADA
A1 TSUNEYO MIMORI
A1 KOICHI AMANO
A1 YASUSHI TANAKA
A1 YASUO MATSUOKA
A1 SUMIKI YAMAMOTO
A1 TSUKASA MATSUBARA
A1 NORIKAZU MURATA
A1 TOMIAKI ASAI
A1 YASUO SUZUKI
YR 2010
UL http://www.jrheum.org/content/37/4/723.abstract
AB Objective. To investigate earlier prediction of future articular destruction in patients with early rheumatoid arthritis (RA). Methods. We randomly allocated patients with RA with disease duration < 2 years to different nonbiologic disease modifying antirheumatic drug (DMARD) therapies in a double-blind trial. Progression of articular destruction over the 96-week treatment period was assessed using the modified Sharp method. Results. Progression of articular destruction correlated more strongly with the American College of Rheumatology (ACR) core set measures after 12 weeks of treatment than with pretreatment values. Multiple regression analysis of data after 12 weeks yielded a correlation coefficient of 0.711. The sensitivity and specificity to predict articular destruction over the 75th percentile of the cohort were 78.6% and 84.6%, respectively. Patients who showed articular destruction over the 75th percentile of the cohort had low response to treatment at 12 weeks, and continued to have high clinical disease activity thereafter. Contrasting data were found in patients with slow progression of articular destruction. Conclusion. In patients with early RA, ACR core set measures after 12 weeks of nonbiologic DMARD treatment may predict articular destruction 2 years later. Low response to treatment at 12 weeks and continuing high disease activity thereafter were found in patients with rapid radiological progression. These data can be used to determine the appropriateness of treatment at 12 weeks and aid the decision to introduce biologic DMARD.