Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Progression Patterns of Radiographic Damage: Results from SONORA Study.

Chen1,  Maggie, Li1,  Xiuying, Akhavan2,  Pooneh, Bombardier3,  Claire

University Health Network
University of Toronto, University Health Network
University of Toronto, University Health Network, Mount Sinai Hospital, Toronto, ON, Canada

Purpose:

Identifying progression patterns and its characteristics for radiographic damage is important to understand early rheumatoid arthritis (RA). Data from the SONORA (study of new-onset rheumatoid arthritis) was analyzed to explore patterns of radiographic progression in early RA patients.

Methods:

A total of 529 patients diagnosed as early RA (symptoms >=3 and <=12 months) and with hand radiographs at baseline, year 1 and 2 were included in this study. The radiographs were scored according to original Sharp method (range 0 to 280) in random order per patient. Radiographic progression was defined by a change of at least 3.5 in total Sharp score within a year. Four patterns of radiographic progression were identified; never progressed, progressed at year 1 only, progressed at year 2 only and progressed at both year 1 and year 2. Demographic and clinical characteristics were compared across these four patterns using ANOVA for continuous outcomes and Chi-square test for categorical outcomes.

Results:

Among these four patterns, 86% subjects never had radiographic progression, 3.4% progressed in the first year only, 7.6% progressed in the second year only and 2.6% progressed in both year 1 and year 2 (table 1). There were significant differences (p< 0.05) between the patients in the four patterns of progression, for, sharp score, CRP, anti-CCP and RF positive. Subjects who had no radiographic progression in two years were those who are younger, had less swollen joint counts, lower DAS score, lower sharp score, lower CRP, anti-CCP negative and RF negative at baseline.

Table 1.

 No progressionProgression at year 2 onlyProgression at year 1 onlyProgression at year 1 and 2 
 N=457N=18N=40N=14P-value
Age52 (13.79)60 (14.45)53 (14.15)57 (18.33)0.05
Baseline swollen joint count4.89 (6.09)2.61 (3.32)6.75 (7.40)8.29 (6.66)0.02
Baseline tender joint count4.88 (6.38)3.89 (5.32)5.90 (7.17)6.35 (6.50)0.55
Baseline DAS3.85 (1.34)3.64 (1.14)4.17 (1.18)4.63 (1.06)0.03
Baseline HAQ1.38 (0.74)0.83 (0.66)1.46 (0.83)1.36 (0.47)0.06
Baseline Sharp score4.06 (5.57)9.33 (11.17)8.28 (8.47)14.0 (19.97)<0.0001
Baseline CRP2.70 (3.17)4.3 (3.69)3.91 (3.94)4.36 (3.70)0.009
Disease duration (days)160 (123)124 (82)146 (93)148 (82)0.55
Anti-CCP positive49.72%61.54%80.77%81.82%0.0003
Male23.41%11.11%32.50%21.43%0.57
Rheumatoid factor positive58.72%66.67%70%78.57%0.04
Ever smoking57.74%41.18%58.82%50%0.57

Conclusion:

The majority of the early RA subjects in routine practice do not have radiographic progression within the first two years of the disease. Very few subjects continuously progressed within 2-year period. Baseline sharp score is the best indicator of whether the subject will progress or not followed by anti-CCP positive, CRP and swollen joint count. These identified indicators can help clinicians to identify the subjects who are at high risk of continuous radiographic progression.

To cite this abstract, please use the following information:
Chen, Maggie, Li, Xiuying, Akhavan, Pooneh, Bombardier, Claire; Progression Patterns of Radiographic Damage: Results from SONORA Study. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1769
DOI: 10.1002/art.29534

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