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.
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: Sergio Ros-Expósito; José Miguel Ruiz-Martín; Pedro Sanz-Frutos; Diana De La Fuente De Dios Journal: Clin Rheumatol Date: 2010-08-10 Impact factor: 2.980
Authors: Harjit P Bhattoa; Zoltán Szekanecz; Boglárka Soós; Ágnes Szentpétery; Hennie G Raterman; Willem F Lems Journal: Nat Rev Rheumatol Date: 2022-03-10 Impact factor: 20.543
Authors: Silvia Hayer; Markus Zeilinger; Volker Weiss; Monika Dumanic; Markus Seibt; Birgit Niederreiter; Tetyana Shvets; Florian Pichler; Wolfgang Wadsak; Bruno K Podesser; Thomas H Helbich; Marcus Hacker; Josef S Smolen; Kurt Redlich; Markus Mitterhauser Journal: J Bone Miner Res Date: 2019-07-30 Impact factor: 6.741