D De Cock1, G Vanderschueren2, S Meyfroidt3, J Joly4, K Van der Elst5, R Westhovens6, P Verschueren6. 1. Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium. Electronic address: diederik.decock@med.kuleuven.be. 2. Department of Radiology, University Hospitals Leuven, Leuven, Belgium. 3. Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium. 4. Department of Rheumatology, University Hospitals Leuven, Leuven, Belgium. 5. Department of Rheumatology, University Hospitals Leuven, Leuven, Belgium; Department of Public Health and Primary Care, Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium. 6. Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium; Department of Rheumatology, University Hospitals Leuven, Leuven, Belgium.
Abstract
OBJECTIVE: To compare in daily clinical practice the reliability of matrices that forecast rapid radiologic progression (RRP) at year one, at year two, and over 2 years in patients with early rheumatoid arthritis (RA). METHODS: Overall, 74 early RA patients with X-rays of hands and feet at baseline, year one, and year two were included. Initial DMARD combination therapy with steroids (ICTS) or DMARD monotherapy (IMT) was initiated according to patients' RA severity, based on rheumatologist opinion. The images were scored via the modified Sharp/van der Heijde (SvH) method. A total Sharp score progression of equal or higher than five per year was considered RRP. Six matrices were tested: ASPIRE CRP/ESR matrices, the BEST matrix, two SWEFOT matrices, and the ESPOIR matrix. Patients were placed in each of them yielding a RRP probability. The performance was tested by Area Under the Curve analysis reflecting the predictive value. RESULTS: Four patients developed RRP in year one, five in year two, and four over 2 years. With regard to face validity, the predicted probability did not correspond to the risk in reality: the one ICTS patient who developed RRP over 2 years was always found in the lowest RRP categories of all matrices. The ASPIRE CRP matrix yielded at least a moderate predicting value for the three time points. The other matrices showed moderate to no predicting value. CONCLUSION: The performance of all matrices was disappointing and it is impossible to fully rely on the existing matrices in daily clinical practice.
OBJECTIVE: To compare in daily clinical practice the reliability of matrices that forecast rapid radiologic progression (RRP) at year one, at year two, and over 2 years in patients with early rheumatoid arthritis (RA). METHODS: Overall, 74 early RApatients with X-rays of hands and feet at baseline, year one, and year two were included. Initial DMARD combination therapy with steroids (ICTS) or DMARD monotherapy (IMT) was initiated according to patients' RA severity, based on rheumatologist opinion. The images were scored via the modified Sharp/van der Heijde (SvH) method. A total Sharp score progression of equal or higher than five per year was considered RRP. Six matrices were tested: ASPIRE CRP/ESR matrices, the BEST matrix, two SWEFOT matrices, and the ESPOIR matrix. Patients were placed in each of them yielding a RRP probability. The performance was tested by Area Under the Curve analysis reflecting the predictive value. RESULTS: Four patients developed RRP in year one, five in year two, and four over 2 years. With regard to face validity, the predicted probability did not correspond to the risk in reality: the one ICTSpatient who developed RRP over 2 years was always found in the lowest RRP categories of all matrices. The ASPIRE CRP matrix yielded at least a moderate predicting value for the three time points. The other matrices showed moderate to no predicting value. CONCLUSION: The performance of all matrices was disappointing and it is impossible to fully rely on the existing matrices in daily clinical practice.
Authors: Patrick Verschueren; Diederik De Cock; Luk Corluy; Rik Joos; Christine Langenaken; Veerle Taelman; Frank Raeman; Isabelle Ravelingien; Klaas Vandevyvere; Jan Lenaerts; Elke Geens; Piet Geusens; Johan Vanhoof; Anne Durnez; Jan Remans; Bert Vander Cruyssen; Els Van Essche; An Sileghem; Griet De Brabanter; Johan Joly; Kristien Van der Elst; Sabrina Meyfroidt; Rene Westhovens Journal: Arthritis Res Ther Date: 2015-04-09 Impact factor: 5.156
Authors: Christopher J Edwards; Patrick Kiely; Subhashini Arthanari; Sandeep Kiri; Julie Mount; Jane Barry; Catherine R Mitchell; Polly Field; Philip G Conaghan Journal: Rheumatol Adv Pract Date: 2019-02-15
Authors: Edit Végh; János Gaál; Pál Géher; Edina Gömöri; Attila Kovács; László Kovács; Katalin Nagy; Edit Feketéné Posta; László Tamási; Edit Tóth; Eszter Varga; Andrea Domján; Zoltán Szekanecz; Gabriella Szűcs Journal: BMC Musculoskelet Disord Date: 2021-04-02 Impact factor: 2.362