The presence of rheumatoid nodules at early rheumatoid arthritis diagnosis is a sign of extra-articular disease and predicts radiographic progression of joint destruction over 5 years
(2011) In Scandinavian Journal of Rheumatology 40(2). p.81-87- Abstract
- Objective: Radiographic damage is an important outcome in rheumatoid arthritis (RA). The disease course varies considerably, and there is a need for simple and reliable prognostic markers. The aim of the study was to determine the utility of early signs of extra-articular disease, manifested as rheumatoid nodules (RN), in predicting radiographic outcome. Methods: In a cohort (n = 1589) of consecutive, newly diagnosed patients with RA, 112 cases with RN at inclusion (7%) were identified. Each case was compared to two age-and sex-matched controls without nodules from the same cohort. Radiographs of the hands and feet were performed at inclusion, after 1, 2, and 5 years and scored according to the modified Sharp van der Heijde Score (SHS;... (More)
- Objective: Radiographic damage is an important outcome in rheumatoid arthritis (RA). The disease course varies considerably, and there is a need for simple and reliable prognostic markers. The aim of the study was to determine the utility of early signs of extra-articular disease, manifested as rheumatoid nodules (RN), in predicting radiographic outcome. Methods: In a cohort (n = 1589) of consecutive, newly diagnosed patients with RA, 112 cases with RN at inclusion (7%) were identified. Each case was compared to two age-and sex-matched controls without nodules from the same cohort. Radiographs of the hands and feet were performed at inclusion, after 1, 2, and 5 years and scored according to the modified Sharp van der Heijde Score (SHS; range 0-448). Results: Fifty-two cases with RN and 139 controls without RN had available radiographs at baseline and after 5 years. Cases were more often rheumatoid factor (RF) positive and anti-cyclic citrullinated peptide (anti-CCP) positive, and had higher disease activity and radiographic damage scores at baseline (7.9 vs. 2.5). After 5 years, there was more extensive radiographic damage among the cases (mean SHS progression 21.7 vs. 13.5). In bivariate analysis, positive RF, positive anti-CCP, SHS, and RN were strong baseline predictors for radiographic progression up to 5 years. In multivariate analysis, positive anti-CCP and SHS at baseline were independently associated with radiographic progression. Conclusion: The presence of RN at baseline is a marker of extra-articular involvement and severe disease, and a predictor of subsequent joint damage. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1868153
- author
- Nyhall-Wahlin, B-M ; Turesson, Carl LU ; Jacobsson, Lennart LU ; Nilsson, Jan-Åke LU ; Forslind, K. ; Albertsson, K. ; Ronnelid, J. and Petersson, Ingemar LU
- organization
- publishing date
- 2011
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Scandinavian Journal of Rheumatology
- volume
- 40
- issue
- 2
- pages
- 81 - 87
- publisher
- Taylor & Francis
- external identifiers
-
- wos:000288127800001
- scopus:79952374043
- pmid:20919947
- ISSN
- 1502-7732
- DOI
- 10.3109/03009742.2010.509103
- language
- English
- LU publication?
- yes
- id
- be083207-7393-4691-84f8-8b53fbdf329d (old id 1868153)
- date added to LUP
- 2016-04-01 10:37:19
- date last changed
- 2024-04-21 16:42:07
@article{be083207-7393-4691-84f8-8b53fbdf329d, abstract = {{Objective: Radiographic damage is an important outcome in rheumatoid arthritis (RA). The disease course varies considerably, and there is a need for simple and reliable prognostic markers. The aim of the study was to determine the utility of early signs of extra-articular disease, manifested as rheumatoid nodules (RN), in predicting radiographic outcome. Methods: In a cohort (n = 1589) of consecutive, newly diagnosed patients with RA, 112 cases with RN at inclusion (7%) were identified. Each case was compared to two age-and sex-matched controls without nodules from the same cohort. Radiographs of the hands and feet were performed at inclusion, after 1, 2, and 5 years and scored according to the modified Sharp van der Heijde Score (SHS; range 0-448). Results: Fifty-two cases with RN and 139 controls without RN had available radiographs at baseline and after 5 years. Cases were more often rheumatoid factor (RF) positive and anti-cyclic citrullinated peptide (anti-CCP) positive, and had higher disease activity and radiographic damage scores at baseline (7.9 vs. 2.5). After 5 years, there was more extensive radiographic damage among the cases (mean SHS progression 21.7 vs. 13.5). In bivariate analysis, positive RF, positive anti-CCP, SHS, and RN were strong baseline predictors for radiographic progression up to 5 years. In multivariate analysis, positive anti-CCP and SHS at baseline were independently associated with radiographic progression. Conclusion: The presence of RN at baseline is a marker of extra-articular involvement and severe disease, and a predictor of subsequent joint damage.}}, author = {{Nyhall-Wahlin, B-M and Turesson, Carl and Jacobsson, Lennart and Nilsson, Jan-Åke and Forslind, K. and Albertsson, K. and Ronnelid, J. and Petersson, Ingemar}}, issn = {{1502-7732}}, language = {{eng}}, number = {{2}}, pages = {{81--87}}, publisher = {{Taylor & Francis}}, series = {{Scandinavian Journal of Rheumatology}}, title = {{The presence of rheumatoid nodules at early rheumatoid arthritis diagnosis is a sign of extra-articular disease and predicts radiographic progression of joint destruction over 5 years}}, url = {{https://lup.lub.lu.se/search/files/1996748/1894761.pdf}}, doi = {{10.3109/03009742.2010.509103}}, volume = {{40}}, year = {{2011}}, }