Document Detail


Repair of joint erosions in rheumatoid arthritis: prevalence and patient characteristics in a large inception cohort.
MedLine Citation:
PMID:  19454405     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Joint destruction in rheumatoid arthritis (RA) was until recently seen as an irreversible state. Lately, it was found that repair of bone erosions occurs; however, little is known about its prevalence. OBJECTIVE: To investigate the frequency of repair and patients' characteristics associated with repair in an inception cohort. PATIENTS AND METHODS: 250 patients with RA, included in the Leiden Early Arthritis Clinic between 1993 and 2000 and treated with conventional disease-modifying antirheumatic drugs, were studied (mean follow-up 10.1 years). Radiographs obtained annually were scored using the Sharp-van der Heijde method, initially aware of the chronology. Patients with a negative change in erosion scores on subsequent radiographs were selected and their series of radiographs were re-scored with concealed time sequence by three readers. Repair was defined as agreement between two readers of a negative change in erosion scores that persisted for at least 2 years. RESULTS: Repair was identified in 32 joints in 18 patients (7.2%). Patients with repair had a greater prevalence of autoantibodies (rheumatoid arthritis, anti-citrullinated protein antibody) and a higher level of joint destruction. In the joints with repair, arthritis was absent in the 2 years preceding repair. CONCLUSIONS: Repair occurred in 7.2% of the patients with RA, particularly in clinically inactive joints in patients with severe destructive disease.
Authors:
Michael P M van der Linden; Ramona Boja; Naomi B Klarenbeek; Tom W J Huizinga; D?sir?e M van der Heijde; Annette H M van der Helm-van Mil
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-05-18
Journal Detail:
Title:  Annals of the rheumatic diseases     Volume:  69     ISSN:  1468-2060     ISO Abbreviation:  Ann. Rheum. Dis.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-18     Completed Date:  2010-04-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372355     Medline TA:  Ann Rheum Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  727-9     Citation Subset:  IM    
Affiliation:
Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands. M.P.M.van_der_Linden@lumc.nl
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antirheumatic Agents / therapeutic use
Arthritis, Rheumatoid / drug therapy,  immunology,  physiopathology*,  radiography
Autoantibodies / analysis
Bone Regeneration / physiology*
Disease Progression
Female
Follow-Up Studies
Humans
Male
Middle Aged
Remission Induction
Severity of Illness Index
Chemical
Reg. No./Substance:
0/Antirheumatic Agents; 0/Autoantibodies

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