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AB0047 Progression of radiological damage in patients with rheumatoid arthritis in clinical in remission; a prospective two year follow-up study
  1. ET Molenaar,
  2. AE Voskuyl,
  3. HJ Dinant,
  4. DP Bezemer,
  5. BA Dijkmans
  1. Rheumatology, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands


Objectives The aim of the present study was to investigate the progression of radiological damage in patients with RA in clinical remission during a follow-up of two years.

Methods RA patients (n = 187), in remission as defined by the ACR/Pinals Criteria were included. Radiographs of hands and feet were made at baseline, and 2 years. Radiological damage was assessed according to the Sharp-van der Heijde method (score ranging from 0–448; (SHS)). SHS at baseline and after two years were compared in the complete cohort as well as in subgroups of patients with persistent remission and those suffering from excacerbations (Wilcoxon test). The following variables, measured at baseline, were assessed as possible riskfactors for radiological progression: number of tender and swollen joints, Ritchie score, Disease Activity Score (DAS), serum titers of IgM and IgA rheumatoid factors, the visual analogue scale (VAS) for the physicians impression of disease activity and the Health Assessment Questionnaire (HAQ) score.

Results At baseline and after two years, the mean SHS of the complete group were 49 and 51 (p < 0.001). In the subgroup of persistant remission, the mean SHS were 52 and 53 (p = 0.004). No significant correlations were found between progression of radiographic damage and baseline variables (rho <0.1, p > 0.1). In the subgroup of exacerbation, the mean SHS were 46 and 51 (p < 0.001). Progression of radiographic damage correlated significantly with the following variables at baseline: SHS (rho 0,40), HAQ-score (rho 0.28), serum IgM-RF (rho 0.29), serum IgA-RF (rho 0.25), but not with the VAS and the DAS.

Conclusion Radiological damage proceeds in RA patients in remission and is not related to disease activity.

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