Document Detail


Functional outcome and subset identification in RA patients from meridional Europe: analysis of a Spanish cohort.
MedLine Citation:
PMID:  12740668     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study was to study the short-term functional and anatomical prognosis of rheumatoid arthritis (RA) in a series of Spanish patients and to identify different subsets of patients as well as possible baseline factors associated with specific outcomes. All patients seen in our division who met the ACR criteria for RA and with disease duration between 2 and 7 years were eligible for the study. Available patients were further evaluated at the clinic for disease activity using biological tests and joint indices as joint counts and Thompson's index, functional capacity using the ACR functional classification (ACR-FC) and the modified Health Assessment Questionnaire (M-HAQ) and radiologic damage by the Sharp's radiologic scoring method. Cluster analysis was used to identify different clinical subsets of patients. One hundred and sixty-three patients were eligible for the study, 13 could not be located or refused to participate and 12 had died. Mean (+/-SD) age at disease onset and mean disease duration were, respectively, 56(+/-14) years and (55+/-20) months. Median (interquartile range) of M-HAQ was 0.4 (0.1-1.1) and 41% of patients were in III or IV ACR-FC. The majority of patients (93%) showed radiologic lesions and 65% had erosions. Cluster analysis identified three subsets: cluster I (70% of patients) was characterised by a good prognosis, cluster II (13%) by a high level of disease activity, and cluster III (17%) by a greater anatomic damage and longer disease duration. No baseline predictive markers were found for these different outcomes. We concluded that RA portends an overall poor short-term prognosis in a relative large percentage of our patients with significant anatomic and functional sequelae. Aggressive management is specially indicated in this subgroup of patients, although definitive prognostic markers for its early identification are still lacking.
Authors:
J Calvo-Alén; A Corrales; S Sánchez-Andrada; M A Fernández-Echevarría; J L Peña; V Rodriguez-Valverde
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Clinical rheumatology     Volume:  22     ISSN:  0770-3198     ISO Abbreviation:  Clin. Rheumatol.     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-05-12     Completed Date:  2003-10-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8211469     Medline TA:  Clin Rheumatol     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  77-83     Citation Subset:  IM    
Affiliation:
Hospital Universitario 'M Valdecilla', Division of Rheumatology, Av Valdecilla s/n, 39006 Santander, Cantabria, Spain.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antirheumatic Agents / therapeutic use
Arthritis, Rheumatoid / diagnosis,  epidemiology*,  physiopathology,  therapy*
Biological Markers
Cohort Studies
Cross-Sectional Studies
Female
Humans
Male
Middle Aged
Orthopedic Procedures
Outcome Assessment (Health Care) / statistics & numerical data*
Prognosis
Retrospective Studies
Risk
Severity of Illness Index
Spain / epidemiology
Chemical
Reg. No./Substance:
0/Antirheumatic Agents; 0/Biological Markers

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