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- Title
Disease Characteristics and Rheumatoid Arthritis Development in Patients with Early Undifferentiated Arthritis: A 2-year Followup Study.
- Authors
Brinkmann, Gina H.; Norli, Ellen S.; Kvien, Tore K.; Haugen, Anne J.; Grøvle, Lars; Nygaard, Halvor; Bjørneboe, Olav; Thunem, Cathrine; Mjaavatten, Maria D.; Lie, Elisabeth
- Abstract
<bold>Objective: </bold>To examine the 2-year disease course in patients with undifferentiated arthritis (UA) focusing on fulfillment of the 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) rheumatoid arthritis (RA) classification criteria.<bold>Methods: </bold>Data were provided by the Norwegian Very Early Arthritis Clinic study, which included patients presenting with ≥ 1 swollen joint of ≤ 16 weeks' duration. UA was defined as patients not fulfilling the 2010 ACR/EULAR RA criteria and who did not have a clinical diagnosis other than RA at baseline. The main outcome was fulfillment of the 2010 RA criteria. Secondary outcomes were disease-modifying antirheumatic drug (DMARD) use, resolution of synovitis without use of DMARD during followup, and final clinical diagnosis.<bold>Results: </bold>We included 477 patients with UA of whom 47 fulfilled the 2010 ACR/EULAR RA criteria during followup (UA-RA) and 430 did not (UA-non-RA). Of the UA-RA patients, 70% fulfilled the criteria within the first 6 months. UA-RA patients were older, more often positive for rheumatoid factor and anticitrullinated protein antibodies, female, and ever smokers, and they more often presented with polyarticular arthritis, small joint involvement, and a swollen shoulder joint. During followup, 53% of UA-RA patients vs 13% of UA-non-RA patients used DMARD (p < 0.001). Overall, 71% of patients with UA achieved absence of clinical synovitis at final followup without use of DMARD. The most frequent final clinical diagnosis was UA (61%).<bold>Conclusion: </bold>Only 9.8% of patients with UA fulfilled the 2010 RA criteria during 2-year followup. Small joint involvement and swollen shoulder joint were among the factors associated with RA development. In two-thirds of patients with UA, the arthritis resolved without use of DMARD.
- Subjects
DRUG therapy for arthritis; ARTHRITIS diagnosis; RHEUMATOID arthritis diagnosis; ANTIRHEUMATIC agents; SYMPTOMS; LONGITUDINAL method; PROGNOSIS; RHEUMATOID arthritis; SEVERITY of illness index; SYNOVITIS; DISEASE progression; DIAGNOSIS
- Publication
Journal of Rheumatology, 2017, Vol 44, Issue 2, p154
- ISSN
0315-162X
- Publication type
journal article
- DOI
10.3899/jrheum.160693