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Erosion-free rheumatoid arthritis : clinical and conceptional implications—a BARFOT study

Svensson, Björn LU ; Andersson, Maria L.E. LU orcid ; Gjertsson, Inger ; Hafström, Ingiäld ; Ajeganova, Sofia and Forslind, Kristina LU (2022) In BMC Rheumatology 6(1).
Abstract

Background: Bone erosions may appear early or later during rheumatoid arthritis (RA), causing joint damage and functional impairment. However, in some patients erosions do not occur, even after several years of disease. This study evaluates the prevalence, clinical relevance and possible predictors of erosion-free RA. Methods: Six hundred and eight patients from an early RA cohort (BARFOT) having radiographs of hands and feet at inclusion and after 1, 2, 5 and 8 years were studied. Clinical and functional assessments were performed on all these time-points. Results: In all, 144 patients (24%) did not develop erosions up to 8 years follow-up (Never erosive group), while 464 patients (76%) had erosions on one or more assessments (Ever... (More)

Background: Bone erosions may appear early or later during rheumatoid arthritis (RA), causing joint damage and functional impairment. However, in some patients erosions do not occur, even after several years of disease. This study evaluates the prevalence, clinical relevance and possible predictors of erosion-free RA. Methods: Six hundred and eight patients from an early RA cohort (BARFOT) having radiographs of hands and feet at inclusion and after 1, 2, 5 and 8 years were studied. Clinical and functional assessments were performed on all these time-points. Results: In all, 144 patients (24%) did not develop erosions up to 8 years follow-up (Never erosive group), while 464 patients (76%) had erosions on one or more assessments (Ever erosive group). At diagnosis, the patients in the Never erosive group were significantly younger, satisfied fewer ACR criteria, and were less frequently RF- and/or anti-CCP- positive compared with those in the Ever erosive group. The Never erosive patients had consistently more tender joints, lower erythrocyte sedimentation rate (ESR) and, from two years and onwards, fewer swollen joints. Absence of rheumatoid factor (RF) and/or anti-CCP were strong independent predictors for erosion-free disease. The erosion-free patients were less frequently treated with DMARDs and/or prednisolone. Conclusions: One-quarter of the patients was erosion-free during eight years in this early RA cohort. Erosion-free patients had a less severe disease course as to disease activity and were more often seronegative compared with those with erosive disease. The results suggest that non-erosive RA represents a milder form of RA.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
ACR criteria, Disease progress, Erosion-free, Erosions, Prognosis, Radiography, Rheumatoid arthritis
in
BMC Rheumatology
volume
6
issue
1
article number
88
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85145361959
  • pmid:36581910
ISSN
2520-1026
DOI
10.1186/s41927-022-00317-4
language
English
LU publication?
yes
id
c974d965-2d07-4e61-bafe-805f4a981e53
date added to LUP
2023-01-16 16:12:53
date last changed
2024-06-14 04:44:00
@article{c974d965-2d07-4e61-bafe-805f4a981e53,
  abstract     = {{<p>Background: Bone erosions may appear early or later during rheumatoid arthritis (RA), causing joint damage and functional impairment. However, in some patients erosions do not occur, even after several years of disease. This study evaluates the prevalence, clinical relevance and possible predictors of erosion-free RA. Methods: Six hundred and eight patients from an early RA cohort (BARFOT) having radiographs of hands and feet at inclusion and after 1, 2, 5 and 8 years were studied. Clinical and functional assessments were performed on all these time-points. Results: In all, 144 patients (24%) did not develop erosions up to 8 years follow-up (Never erosive group), while 464 patients (76%) had erosions on one or more assessments (Ever erosive group). At diagnosis, the patients in the Never erosive group were significantly younger, satisfied fewer ACR criteria, and were less frequently RF- and/or anti-CCP- positive compared with those in the Ever erosive group. The Never erosive patients had consistently more tender joints, lower erythrocyte sedimentation rate (ESR) and, from two years and onwards, fewer swollen joints. Absence of rheumatoid factor (RF) and/or anti-CCP were strong independent predictors for erosion-free disease. The erosion-free patients were less frequently treated with DMARDs and/or prednisolone. Conclusions: One-quarter of the patients was erosion-free during eight years in this early RA cohort. Erosion-free patients had a less severe disease course as to disease activity and were more often seronegative compared with those with erosive disease. The results suggest that non-erosive RA represents a milder form of RA.</p>}},
  author       = {{Svensson, Björn and Andersson, Maria L.E. and Gjertsson, Inger and Hafström, Ingiäld and Ajeganova, Sofia and Forslind, Kristina}},
  issn         = {{2520-1026}},
  keywords     = {{ACR criteria; Disease progress; Erosion-free; Erosions; Prognosis; Radiography; Rheumatoid arthritis}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Rheumatology}},
  title        = {{Erosion-free rheumatoid arthritis : clinical and conceptional implications—a BARFOT study}},
  url          = {{http://dx.doi.org/10.1186/s41927-022-00317-4}},
  doi          = {{10.1186/s41927-022-00317-4}},
  volume       = {{6}},
  year         = {{2022}},
}