Document Detail


Disease activity, smoking, and reproductive-related predictors of poor prognosis in patients with very early inflammatory polyarthritis.
MedLine Citation:
PMID:  21123320     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To identify disease activity, smoking, and reproductive-related predictors of a poor prognosis in patients with very early inflammatory polyarthritis (IP).
METHODS: Patients with very early IP (symptom duration 4-11 weeks) included in our study were participants in the STIVEA (Steroids In Very Early Arthritis) randomized placebo-controlled trial. At baseline, disease-related variables were measured and patients were asked to complete a questionnaire covering smoking status and reproductive questions. Baseline predictors of poor prognosis [i.e., the need to start disease-modifying antirheumatic drug (DMARD) therapy by 6 months or the clinical diagnosis of rheumatoid arthritis (RA) at 12 months] were identified, applying logistic regression analyses adjusted for treatment group.
RESULTS: Rheumatoid factor (RF) positivity was one of the strongest clinical predictors of a poor prognosis: OR for DMARD therapy at 6 months, 4.00 (95% CI 2.00-8.00) and OR for a diagnosis of RA at 12 months, 9.48 (95% CI 4.48-20.07). There was a significant association between current smoking at baseline compared to never smoking and a diagnosis of RA at 12 months (OR 3.15, 95% CI 1.16-8.56).
CONCLUSION: About 6 in 7 patients with very early RF-positive IP were diagnosed with RA 1 year later. In addition, 1 in 4 IP patients who smoke will develop RA later. It is recommended to treat RF-positive patients who have IP with DMARD at presentation and to advise patients to stop smoking.
Authors:
Suzanne M M Verstappen; Melanie J McCoy; Chris Roberts; Nicola E Dale; Andrew B Hassell; Deborah P M Symmons;
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-12-01
Journal Detail:
Title:  The Journal of rheumatology     Volume:  38     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-02     Completed Date:  2011-06-20     Revised Date:  2011-12-01    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  429-33     Citation Subset:  IM    
Affiliation:
The University of Manchester, Manchester M13 9PT, UK.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antirheumatic Agents / therapeutic use
Arthritis / diagnosis*,  drug therapy,  immunology,  physiopathology*
Female
Humans
Middle Aged
Placebos
Prognosis
Questionnaires
Reproduction*
Smoking*
Grant Support
ID/Acronym/Agency:
//Arthritis Research UK
Chemical
Reg. No./Substance:
0/Antirheumatic Agents; 0/Placebos
Investigator
Investigator/Affiliation:
Diarmuid Mulherin / ; P T Dawes / ; David Scott / ; Susan Knight / ; Martin Davis / ; Jeff Marks / ; Ian Bruce / ; George Kitas / ; Terry O'Neill / ; Marwan Bukhari / ; Karl Gaffney / ; Karim Raza / ; Lesley Kay / ; Clive Kelly / ; Vadivelu Saravanan / ; Stuart Linton / ; Cathy Laversuch / ; Rikki Abernethy / ; Kuntal Chakravarty / ; Selwyn Richards / ; Brian Bourke / ; Alison Leak / ; Raad Makadsi / ; Ysbyty Gwynedd / ; Peter Maddison /

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Wegener's granulomatosis strictly and persistently localized to one organ is rare: assessment of 16 ...
Next Document:  High titers of autoantibodies in patients with sickle-cell disease.