Osteoarthritis in Weight-Bearing Wrists?

Objective. To develop a clinical model for the prediction, at the first visit, of 3 forms of arthritis outcome: self-limiting, persistent nonerosive, and persistent erosive arthritis.Methods. A standardized diagnostic evaluation was performed on 524 consecutive, newly referred patients with early arthritis. Potentially diagnostic determinants obtained at the first visit from the patient's history, physical examination, and blood and imaging testing were entered in a logistic regression analysis. Arthritis outcome was recorded at 2 years' followup. The discriminative ability of the model was expressed as a receiver operating characteristic (ROC) area under the curve (AUC).Results

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How to diagnose rheumatoid arthritis early: A prediction model for persistent (erosive) arthritis

Visser¹,

Cessie²,

Vos³

et al. 2002

Arthritis & Rheumatism

634

368

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Radiographic healing with sustained clinical remission in a patient with rheumatoid arthritis receiving methotrexate monotherapy

Wassenberg¹,

Rau²

2002

Arthritis & Rheumatism

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Prognostic markers of radiographic progression in early rheumatoid arthritis

Goronzy

Matteson

Fulbright

et al. 2004

Arthritis & Rheumatism

147

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Objective. To identify prognostic markers that are predictive of progressive erosive disease in patients with early rheumatoid arthritis (RA).Methods. The study involved an inception cohort of 111 consecutive patients with RA and a disease duration of <1 year. Patients were treated according to an algorithm designed to avoid overtreatment of mild disease and to accelerate treatment in patients who had continuous disease activity. Patients were evaluated for the presence of clinical and laboratory disease activity markers. We determined the frequency of CD4؉,CD28 null T cells by flow cytometry, HLA-DRB1 gene polymorphisms by polymerase chain reaction (PCR)/sequencing, and 26 single-nucleotide polymorphisms in 19 candidate genes by multiplex PCR and hybridization to an immobilized probe array. Data were analyzed using proportional odds models to identify prognostic markers predictive of erosive progression over 2 years on serial hand/wrist radiographs.Results. After 2 years, disease activity in 52% of the cohort was controlled by treatment with hydroxychloroquine and nonsteroidal agents. Forty-eight percent of the patients did not develop erosions. Older age, presence of erosions at baseline, presence of rheumatoid factor, rheumatoid factor titer, and HLA-DRB1*04 alleles, particularly homozygosity for HLA-DRB1*04, were univariate predictors of radiographic progression. Promising novel markers were the frequency of CD4؉,CD28 null T cells as an immunosenescence indicator, and a polymorphism in the uteroglobin gene.Conclusion. Clinical disease activity in patients with early RA can frequently be controlled with nonaggressive treatment, but this is not always sufficient to prevent new erosions. Rheumatoid factor titer, HLA-DRB1 polymorphisms, age, and immunosenescence markers are predictors of poor radiographic outcome. A polymorphism in the uteroglobin gene may identify patients who have a low risk of erosive disease.

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Osteoarthritis in Weight-Bearing Wrists?

Cited by 21 publications

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How to diagnose rheumatoid arthritis early: A prediction model for persistent (erosive) arthritis

How to diagnose rheumatoid arthritis early: A prediction model for persistent (erosive) arthritis

Radiographic healing with sustained clinical remission in a patient with rheumatoid arthritis receiving methotrexate monotherapy

Prognostic markers of radiographic progression in early rheumatoid arthritis

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