Current smoking status is a strong predictor of radiographic progression in early rheumatoid arthritis: results from the SWEFOT trial
(2015) In Annals of the Rheumatic Diseases 74(8). p.1509-1514- Abstract
- Objectives To study clinical predictors for radiographic progression after 1 year in an early rheumatoid arthritis (RA) trial. Methods In the SWEFOT trial population, disease modifying antirheumatic drug (DMARD) naive RA patients started methotrexate; 3-month responders (DAS28 <3.2) continued (n=147), while non-responders were randomised to addition of sulfasalazine +hydroxychloroquine (n=130) or infliximab (n=128). X-rays were scored by the Sharp-van der Hejde score (SHS) method and radiographic progression was defined as a >= 5 increase after 1 year. Potential baseline predictors of radiographic progression were tested using multivariable logistic regression, adjusted for potential confounders. Results 79 of 311 patients with... (More)
- Objectives To study clinical predictors for radiographic progression after 1 year in an early rheumatoid arthritis (RA) trial. Methods In the SWEFOT trial population, disease modifying antirheumatic drug (DMARD) naive RA patients started methotrexate; 3-month responders (DAS28 <3.2) continued (n=147), while non-responders were randomised to addition of sulfasalazine +hydroxychloroquine (n=130) or infliximab (n=128). X-rays were scored by the Sharp-van der Hejde score (SHS) method and radiographic progression was defined as a >= 5 increase after 1 year. Potential baseline predictors of radiographic progression were tested using multivariable logistic regression, adjusted for potential confounders. Results 79 of 311 patients with available radiographs at baseline and follow-up had radiographic progression. The following baseline parameters were independent predictors of radiographic progression at 1 year: baseline erosions (adjusted OR=2.29, 95% CI 1.24 to 4.24), erythrocyte sedimentation rate (adjusted OR per tertile increase=1.72, 95% CI 1.12 to 2.65) and C-reactive protein (adjusted OR per tertile increase=1.52, 95% CI 1.03 to 2.26). Current smoking was an independent predictor of radiographic progression (adjusted OR=2.17, 95% CI 1.06 to 4.45). These results remained after further adjustment for treatment strategy. Three-dimensional matrix including current smoking status, erosions and C-reactive protein tertiles showed a 12-63% risk gradient from patients carrying none compared with all predictors. Rheumatoid factor (RF)/anti-cyclic citrullinated peptide (anti-CCP) positivity did not significantly predict radiographic progression using SHS increase >= 5 as cut-off. In a secondary exploratory analysis using cut-off > 1, both RF and anti-CCP positivity were significant predictors in the unadjusted, but not the adjusted analyses. The other parameters also remained significant using this lower cut-off. Conclusions In addition to previously described predictors, we identified smoking as a strong independent risk factor for radiographic progression in early RA. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/7779724
- author
- Saevarsdottir, Saedis ; Rezaei, Hamed ; Geborek, Pierre LU ; Petersson, Ingemar ; Ernestam, Sofia ; Albertsson, Kristina ; Forslind, Kristina LU and van Vollenhoven, Ronald F.
- organization
- publishing date
- 2015
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Annals of the Rheumatic Diseases
- volume
- 74
- issue
- 8
- pages
- 1509 - 1514
- publisher
- BMJ Publishing Group
- external identifiers
-
- wos:000357683600017
- scopus:84940374597
- pmid:24706006
- ISSN
- 1468-2060
- DOI
- 10.1136/annrheumdis-2013-204601
- language
- English
- LU publication?
- yes
- id
- 7a956742-db1b-40fb-a388-2eb7536f0789 (old id 7779724)
- date added to LUP
- 2016-04-01 13:50:36
- date last changed
- 2022-04-14 03:27:20
@article{7a956742-db1b-40fb-a388-2eb7536f0789,
abstract = {{Objectives To study clinical predictors for radiographic progression after 1 year in an early rheumatoid arthritis (RA) trial. Methods In the SWEFOT trial population, disease modifying antirheumatic drug (DMARD) naive RA patients started methotrexate; 3-month responders (DAS28 <3.2) continued (n=147), while non-responders were randomised to addition of sulfasalazine +hydroxychloroquine (n=130) or infliximab (n=128). X-rays were scored by the Sharp-van der Hejde score (SHS) method and radiographic progression was defined as a >= 5 increase after 1 year. Potential baseline predictors of radiographic progression were tested using multivariable logistic regression, adjusted for potential confounders. Results 79 of 311 patients with available radiographs at baseline and follow-up had radiographic progression. The following baseline parameters were independent predictors of radiographic progression at 1 year: baseline erosions (adjusted OR=2.29, 95% CI 1.24 to 4.24), erythrocyte sedimentation rate (adjusted OR per tertile increase=1.72, 95% CI 1.12 to 2.65) and C-reactive protein (adjusted OR per tertile increase=1.52, 95% CI 1.03 to 2.26). Current smoking was an independent predictor of radiographic progression (adjusted OR=2.17, 95% CI 1.06 to 4.45). These results remained after further adjustment for treatment strategy. Three-dimensional matrix including current smoking status, erosions and C-reactive protein tertiles showed a 12-63% risk gradient from patients carrying none compared with all predictors. Rheumatoid factor (RF)/anti-cyclic citrullinated peptide (anti-CCP) positivity did not significantly predict radiographic progression using SHS increase >= 5 as cut-off. In a secondary exploratory analysis using cut-off > 1, both RF and anti-CCP positivity were significant predictors in the unadjusted, but not the adjusted analyses. The other parameters also remained significant using this lower cut-off. Conclusions In addition to previously described predictors, we identified smoking as a strong independent risk factor for radiographic progression in early RA.}},
author = {{Saevarsdottir, Saedis and Rezaei, Hamed and Geborek, Pierre and Petersson, Ingemar and Ernestam, Sofia and Albertsson, Kristina and Forslind, Kristina and van Vollenhoven, Ronald F.}},
issn = {{1468-2060}},
language = {{eng}},
number = {{8}},
pages = {{1509--1514}},
publisher = {{BMJ Publishing Group}},
series = {{Annals of the Rheumatic Diseases}},
title = {{Current smoking status is a strong predictor of radiographic progression in early rheumatoid arthritis: results from the SWEFOT trial}},
url = {{https://lup.lub.lu.se/search/files/3618435/8619296}},
doi = {{10.1136/annrheumdis-2013-204601}},
volume = {{74}},
year = {{2015}},
}