rss
Ann Rheum Dis 2005;64:196-201 doi:10.1136/ard.2003.019992
  • Extended report

Prognostic laboratory markers of joint damage in rheumatoid arthritis

  1. E Lindqvist1,
  2. K Eberhardt1,
  3. K Bendtzen2,
  4. D Heinegård3,
  5. T Saxne1
  1. 1Department of Rheumatology, Lund University Hospital, Lund, Sweden
  2. 2Institute for Inflammation Research, Rigshospitalet National University Hospital, Copenhagen, Denmark
  3. 3Department of Cell and Molecular Biology, Section for Connective Tissue Biology, Lund University
  1. Correspondence to:
    Dr Elisabet Lindqvist
    Department of Rheumatology, Lund University Hospital, S-221 85 Lund, Sweden; elisabet.lindqvistreum.lu.se
  • Accepted 6 July 2004
  • Published Online First 30 September 2004

Abstract

Objective: To investigate whether determination of a set of laboratory markers at baseline provides prognostic information on joint damage in hands and feet in rheumatoid arthritis.

Methods: 183 patients with early rheumatoid arthritis included in a prospective study were examined. Radiographic changes in hands and feet at 5 and 10 years after inclusion were evaluated (Larsen). The markers analysed were: erythrocyte sedimentation rate (ESR); HLA-DRB alleles typed by restriction fragment length polymorphism; and C reactive protein, cartilage oligomeric matrix protein (COMP), rheumatoid factor (RF) (IgG, IgA, and IgM subtypes), antibodies against cyclic citrullinated peptide (anti-CCP), and antibodies against interleukin 1α (anti-IL1α), analysed by immunoassays. Multiple linear regression with backward elimination was used to determine the prognostic value of the variables.

Results: 117/176 patients were positive for IgG RF, 138/176 for IgA RF, 139/176 for IgM RF, 140/176 for anti-CCP, and 40/182 for anti-IL1α. After five years, ESR, the presence of IgA RF, serum COMP, and the presence of anti-CCP were significantly associated with more severe joint damage, and the presence of anti-IL1α with less severe joint damage. Baseline C reactive protein and anti-CCP predicted radiographic outcome after 10 years. A stronger prediction was obtained by combining the prognostic factors.

Conclusions: Early determination of anti-CCP, IgA RF, anti-IL-1α, ESR, C reactive protein, and COMP predicted the development of joint damage in hands and feet in this cohort. A combination of these measures reflecting different aspects of the disease process should be useful for evaluating prognosis in individual patients with early rheumatoid arthritis.

Footnotes

    This Article

    1. Abstract
    2. Full text
    3. PDF
    4. All versions of this article:
      1. ard.2003.019992v1
      2. 64/2/196 most recent

    Responses

    1. Submit a response
    2. No responses published

    Register for free content

    The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

    Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.