Lewis Carpenter1, Sam Norton2, Elena Nikiphorou3, Keeranur Jayakumar4, Daniel F McWilliams5, Kirsten L Rennie1, Josh Dixey6, Patrick Kiely7, David Andrew Walsh5, Adam Young4. 1. Centre for Clinical and Health Service Research, University of Hertfordshire, Hatfield, UK. 2. Institute of Psychiatry, Psychology and Neuroscience, University of Hertfordshire, Hatfield, UK. 3. Whittington Hospital NHS Trust, London, UK. 4. University of Hertfordshire, Hatfield, UK. 5. Arthritis UK Pain Centre, University of Nottingham, Nottingham, UK. 6. New Cross Hospital, Wolverhampton, UK. 7. St Georges University Hospitals NHS Foundation Trust, London, UK.
Abstract
OBJECTIVE: To assess the 5-year progression of erosions and joint space narrowing (JSN) and their associations with rheumatoid factor (RF) status in 2 large, multicenter, early rheumatoid arthritis cohorts, spanning 25 years. METHODS: Radiographic joint damage was recorded using the Sharp/van der Heijde (SHS) method in the Early Rheumatoid Arthritis Study (ERAS), 1986-2001, and the Early Rheumatoid Arthritis Network (ERAN), 2002-2013. Mixed-effects negative binomial regression estimated changes in radiographic damage over 5 years, including erosions and JSN, separately. RF, along with age, sex, and baseline markers of disease activity were controlled for. RESULTS: A total of 1,216 patients from ERAS and 446 from ERAN had radiographic data. Compared to ERAS, ERAN patients had a lower mean total SHS score at baseline (ERAN 6.2 versus ERAS 10.5; P < 0.001) and mean annual rate of change (ERAN 2.5 per year versus ERAS 6.9 per year; P < 0.001). Seventy-four percent of ERAS and 27% of ERAN patients progressed ≥5 units. Lower scores at baseline in ERAN were largely driven by reductions in JSN (ERAS 3.9 versus ERAN 1.2; P < 0.001), along with erosions (ERAS 1.9 versus ERAN 0.8; P < 0.001). RF was associated with greater progression in each cohort, but the absolute difference in mean annual rate of change for RF-positive patients was substantially higher for ERAS (RF positive 8.6 versus RF negative 5.1; P < 0.001), relative to ERAN (RF positive 2.0 versus RF negative 1.9; P = 0.855). CONCLUSION: Radiographic progression was shown to be significantly reduced between the 2 cohorts, and was associated with lower baseline damage and other factors, including changes in early disease-modifying antirheumatic drug use. The impact of RF status as a prognostic marker of clinically meaningful change in radiographic progression has markedly diminished in the context of more modern treatment.
OBJECTIVE: To assess the 5-year progression of erosions and joint space narrowing (JSN) and their associations with rheumatoid factor (RF) status in 2 large, multicenter, early rheumatoid arthritis cohorts, spanning 25 years. METHODS: Radiographic joint damage was recorded using the Sharp/van der Heijde (SHS) method in the Early Rheumatoid Arthritis Study (ERAS), 1986-2001, and the Early Rheumatoid Arthritis Network (ERAN), 2002-2013. Mixed-effects negative binomial regression estimated changes in radiographic damage over 5 years, including erosions and JSN, separately. RF, along with age, sex, and baseline markers of disease activity were controlled for. RESULTS: A total of 1,216 patients from ERAS and 446 from ERAN had radiographic data. Compared to ERAS, ERAN patients had a lower mean total SHS score at baseline (ERAN 6.2 versus ERAS 10.5; P < 0.001) and mean annual rate of change (ERAN 2.5 per year versus ERAS 6.9 per year; P < 0.001). Seventy-four percent of ERAS and 27% of ERAN patients progressed ≥5 units. Lower scores at baseline in ERAN were largely driven by reductions in JSN (ERAS 3.9 versus ERAN 1.2; P < 0.001), along with erosions (ERAS 1.9 versus ERAN 0.8; P < 0.001). RF was associated with greater progression in each cohort, but the absolute difference in mean annual rate of change for RF-positive patients was substantially higher for ERAS (RF positive 8.6 versus RF negative 5.1; P < 0.001), relative to ERAN (RF positive 2.0 versus RF negative 1.9; P = 0.855). CONCLUSION: Radiographic progression was shown to be significantly reduced between the 2 cohorts, and was associated with lower baseline damage and other factors, including changes in early disease-modifying antirheumatic drug use. The impact of RF status as a prognostic marker of clinically meaningful change in radiographic progression has markedly diminished in the context of more modern treatment.
Authors: Ana M Santos; Eugenia-Lucía Saldarriaga; Rodrigo Giraldo-Bustos; Jesus Giovanny Ballesteros-Muñoz; Juan C Rueda; Francy-Milena Cuervo; José-Ignacio Angarita; Andrés Y Vásquez; Sofía Arias-Correal; Camilo A González; Pedro Santos-Moreno; John Londono Journal: Clin Rheumatol Date: 2017-12-27 Impact factor: 2.980
Authors: Elena Nikiphorou; Sam J Norton; Lewis Carpenter; David A Walsh; Paul Creamer; Josh Dixey; Adam Young; Patrick D W Kiely Journal: Rheumatology (Oxford) Date: 2020-06-01 Impact factor: 7.580
Authors: Lewis Carpenter; Sam Norton; Elena Nikiphorou; Patrick Kiely; David A Walsh; Josh Dixey; Adam Young Journal: Rheumatol Int Date: 2018-10-27 Impact factor: 2.631
Authors: Peter M Ten Klooster; Letty G A Versteeg; Martijn A H Oude Voshaar; Inmaculada de la Torre; Francesco De Leonardis; Walid Fakhouri; Liliana Zaremba-Pechmann; Mart van de Laar Journal: Arthritis Res Ther Date: 2019-11-12 Impact factor: 5.156
Authors: Lewis Carpenter; Elena Nikiphorou; Patrick D W Kiely; David A Walsh; Adam Young; Sam Norton Journal: Rheumatology (Oxford) Date: 2020-09-01 Impact factor: 7.580