Radiological damage in patients with rheumatoid arthritis on sustained remission

被引:95
作者
Cohen, G.
Gossec, L.
Dougados, M.
Cantagrel, A.
Goupille, P.
Daures, J. P.
Rincheval, N.
Combe, B.
机构
[1] Univ Ctr Hosp Univ Lapeyronie, Hop Lapeyronie, Serv Immuno Rhumatol, F-34295 Montpellier 5, France
[2] Univ Paris 05, Cochin Hosp, Dept Rheumatol B, Paris, France
[3] Ctr Hosp Univ Rangueil, Serv Rhumatol, Toulouse, France
[4] Ctr Hosp Univ Tours, Serv Rhumatol, Tours, France
[5] Inst Univ Rech Clin, Lab Biostat & Epidemiol, Montpellier, France
关键词
D O I
10.1136/ard.2006.057497
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
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收藏
页码:358 / 363
页数:6
相关论文
共 62 条
[1]   THE AMERICAN-RHEUMATISM-ASSOCIATION 1987 REVISED CRITERIA FOR THE CLASSIFICATION OF RHEUMATOID-ARTHRITIS [J].
ARNETT, FC ;
EDWORTHY, SM ;
BLOCH, DA ;
MCSHANE, DJ ;
FRIES, JF ;
COOPER, NS ;
HEALEY, LA ;
KAPLAN, SR ;
LIANG, MH ;
LUTHRA, HS ;
MEDSGER, TA ;
MITCHELL, DM ;
NEUSTADT, DH ;
PINALS, RS ;
SCHALLER, JG ;
SHARP, JT ;
WILDER, RL ;
HUNDER, GG .
ARTHRITIS AND RHEUMATISM, 1988, 31 (03) :315-324
[2]   STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT [J].
BLAND, JM ;
ALTMAN, DG .
LANCET, 1986, 1 (8476) :307-310
[3]   Determination of the minimal clinically important difference in rheumatoid arthritis joint damage of the Sharp/van der Heijde and Larsen/Scott scoring methods by clinical experts and comparison with the smallest detectable difference [J].
Bruynesteyn, K ;
van der Heijde, D ;
Boers, M ;
Saudan, A ;
Peloso, P ;
Paulus, H ;
Houben, H ;
Griffiths, B ;
Edmonds, J ;
Bresnihan, B ;
Boonen, A ;
van der Linden, S .
ARTHRITIS AND RHEUMATISM, 2002, 46 (04) :913-920
[4]  
COMBE B, 1995, BRIT J RHEUMATOL, V34, P529
[5]  
Combe B, 2003, J RHEUMATOL, V30, P2344
[6]  
Combe B, 2001, ARTHRITIS RHEUM, V44, P1736, DOI 10.1002/1529-0131(200108)44:8<1736::AID-ART308>3.0.CO
[7]  
2-I
[8]   Elucidation of the relationship between synovitis and bone damage - A randomized magnetic resonance imaging study of individual joints in patients with early rheumatoid arthritis [J].
Conaghan, PG ;
O'Connor, P ;
McGonagle, D ;
Astin, P ;
Wakefield, RJ ;
Gibbon, WW ;
Quinn, M ;
Karim, Z ;
Green, MJ ;
Proudman, S ;
Isaacs, J ;
Emery, P .
ARTHRITIS AND RHEUMATISM, 2003, 48 (01) :64-71
[9]   Combination therapy in early rheumatoid arthritis: a randomised, controlled, double blind 52 week clinical trial of sulphasalazine and methotrexate compared with the single components [J].
Dougados, M ;
Combe, B ;
Cantagrel, A ;
Goupille, P ;
Olive, P ;
Schattenkirchner, M ;
Meussr, S ;
Paimela, L ;
Rau, R ;
Zeidler, H ;
Leirisalo-Repo, M ;
Peldan, K .
ANNALS OF THE RHEUMATIC DISEASES, 1999, 58 (04) :220-225
[10]  
Eberhardt K, 1998, BRIT J RHEUMATOL, V37, P1324