Assessing the risk of rapid radiographic progression in Hungarian rheumatoid arthritis patients

BMC Musculoskeletal Disorders

Pál Géher¹  László Kovács²  László Tamási³  Edit Tóth⁴  Katalin Nagy⁵  Attila Kovács⁶  Eszter Varga⁷  Edina Gömöri⁸  János Gaál⁹  Gabriella Szűcs^1,10  Andrea Domján^1,10  Zoltán Szekanecz^1,10  Edit Végh^1,10  Edit Feketéné Posta^1,10 

[1] Department of Rheumatology and Immunology, Faculty of Medicine, Semmelweis University;Department of Rheumatology and Immunology, University of Szeged, Faculty of Medicine;Department of Rheumatology, Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital;Department of Rheumatology, Ferenc Flór Hospital;Department of Rheumatology, Ferenc Markhot Hospital;Department of Rheumatology, Hospital of State Railways;Department of Rheumatology, Markusovszky Hospital;Department of Rheumatology, Pándy Hospital;Department of Rheumatology, University of Debrecen Kenézy Teaching Hospital;Department of Rheumatology, University of Debrecen, Faculty of Medicine;

关键词: Rheumatoid arthritis;    Anti-TNF therapy;    Infliximab;    Biological therapy;    Outcome;    Rapid radiographic progression;   

DOI  :  10.1186/s12891-021-04192-x

来源: DOAJ

【 摘 要 】

Abstract Background The outcome of rheumatoid arthritis (RA) should be determined early. Rapid radiological progression (RRP) is > or = 5 units increase according to the van der Heijde-Sharp score within a year. The risk of RRP can be estimated by a matrix model using non-radiographic indicators, such as C-reactive protein (CRP), rheumatoid factor (RF) and swollen joint count (SJC). Patients and methods A non-interventional, cross-sectional, retrospective study was conducted in eleven Hungarian arthritis centres. We assessed RRP risk in biologic-naïve RA patients with the prevalence of high RRP risk as primary endpoint. RRP was calculated according to this matrix model. As a secondary endpoint, we compared RRP in methotrexate (MTX) responders vs non-responders. Results We analyzed data from 1356 patients. Mean CRP was 17.7 mg/l, RF was 139.3 IU/ml, mean 28-joint disease activity score (DAS28) was 5.00 and mean SJC was 6.56. Altogether 18.2% of patients had high risk (≥40%) of RRP. RA patients with high RRP risk of RRP (n = 247) had significantly lower age compared to those with RRP < 40% (n = 1109). MTX non-response (OR: 16.84), male gender (OR: 1.67), erosions at baseline (OR: 1.50) and ACPA seropositivity (OR: 2.18) were independent predictors of high-risk RRP. Male gender (OR: 5.20), ACPA seropositivity (OR: 4.67) and erosions (OR: 7.98) were independent predictors of high RRP risk in MTX responders. Conclusions In this Hungarian study, high RRP risk occurred in 18% of RA patients. These patients differ from others in various parameters. RRP was associated with non-response to MTX.

【 授权许可】

Unknown