AI Article Synopsis
- The study aimed to identify prognostic factors for clinically relevant radiographic progression (CRRP) in rheumatoid arthritis (RA) patients who achieved remission or low disease activity after treatment.
- Using data from a multicenter study in Japan involving 198 RA patients treated with DMARDs, the researchers defined CRRP based on a specific progression score and conducted statistical analyses to determine predicting factors.
- Key findings indicated that positivity for anti-citrullinated peptide antibodies (ACPA), time-integrated disease activity scores, and baseline modified total Sharp scores were significant predictors of CRRP, highlighting ACPA positivity as a strong indicator of poor long-term radiographic outcomes in these patients.
Article Abstract
Objectives: To determine prognostic factors of clinically relevant radiographic progression (CRRP) in patients with rheumatoid arthritis (RA) achieving remission or low disease activity (LDA) in clinical practice.
Methods: Using data from a nationwide, multicenter, prospective study in Japan, we evaluated 198 biological disease-modifying antirheumatic drug (bDMARD)-naïve RA patients who were in remission or had LDA at study entry after being treated with conventional synthetic DMARDs (csDMARDs). CRRP was defined as the yearly progression of modified total Sharp score (mTSS) >3.0 U. We performed a multiple logistic regression analysis to explore the factors to predict CRRP at 1 year. We used receiver operating characteristic (ROC) curve to estimate the performance of relevant variables for predicting CRRP.
Results: The mean Disease Activity Score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR) was 2.32 ± 0.58 at study entry. During the 1-year observation, remission or LDA persisted in 72% of the patients. CRRP was observed in 7.6% of the patients. The multiple logistic regression analysis revealed that the independent variables to predict the development of CRRP were: anti-citrullinated peptide antibodies (ACPA) positivity at baseline (OR = 15.2, 95%CI 2.64-299), time-integrated DAS28-ESR during the 1 year post-baseline (7.85-unit increase, OR = 1.83, 95%CI 1.03-3.45), and the mTSS at baseline (13-unit increase, OR = 1.22, 95%CI 1.06-1.42).
Conclusions: ACPA positivity was the strongest independent predictor of CRRP in patients with RA in remission or LDA. Physicians should recognize ACPA as a poor-prognosis factor regarding the radiographic outcome of RA, even among patients showing a clinically favorable response to DMARDs.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5432072 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0175281 | PLOS |
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