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Study: Undetectable joint progression in patients with RA may be rare
About 5.8% of patients with rheumatoid arthritis had undetected joint progression compared with 43% of studied patients who had radiographic progression during a 3-year to 5-year observation period, according to results of a recently published study.
Researchers studied 279 patients with rheumatoid arthritis who had radiographs of up to 22 hand and wrist joints during the observation period. All images were scored using the Sharp van der Heijde score (SHS) and compared by the same interpreter. Laboratory assessments included C-reactive protein and erythrocyte sedimentation rate as well as rheumatoid factor and anti-citrullinated peptide antibodies.
The mean observation period was 4.1 years. During that time, 57% (n = 159) of patients who had radiographic joint progression also presented with swollen or tender joints. Of the patients with changes, 39.6% of patients had observable joint space narrowing changes, 13.9% of patients had changes in joint space narrowing scores and 46.5% of patients had changes in both. For 132 of the 159 patients, the clinical activity was observed in the year before the baseline radiographic assessment, not after the first radiographic assessment.
Despite the absence of swelling or tender joints, 43% of patients had radiographic progression in certain joints without visible activity, but disease activity was present in other joints. About 5.8% of patients who had no detectable clinical activity in other joints demonstrated radiographic progression over the observational period.
Baseline SHS was higher and poorer disease activity scores were observed in patients who demonstrated radiographic progression. No significant differences were observed between patients who received conventional disease-modifying anti-rheumatic drugs or biological agents. – by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.