Objectives To investigate the progression of radiological damage in patients with RA in remission during a follow-up of 2 years.
Methods RA patients (n = 187), in remission according to the ACR/Pinals criteria were included. Radiographs of hands and feet were made at baseline and after 2 years. Radiological damage was assessed according to the Sharp-van der Heijde method (range score 0–448; (SHS)). SHS at baseline and after 2 years were compared in the complete group and in subgroups of patients with persistent remission and in those suffering an exacerbation (Wilcoxon test). As riskfactors for radiological progression were analysed: number of tender and swollen joint, Ritchie score, Disease Activity Score (DAS), serum rheumatoid factors, Visual Analogue Scale for physicians impression of disease activity (VAS, range 0–100), and Health Assessment Questionnaire (HAQ) score.
Results At baseline and after 2 years, the mean SHS of the complete group were 49 and 51 (p < 0.001). In the subgroup with persistent remission, the mean SHS were 52 and 53 (P = 0.004). No significant correlations were found between radiological damage and variables at baseline (rho0.1). In the subgroup of patients with an exacerbation, the mean SHS were 46 and 51 (p < 0.001). Progression of radioolgical damage correlated significantly with the following baseline variables: SHS(rho = 0.40), HAQ-score (rho = 0.28), IgM-RF (rho = 0.29), IgA-RF (0.25); but not with the DAS or VAS.
Conclusion Radiological damage proceeds in RA patients in remission and is not related to disease activity.
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