Background Three matrices, ASPIRE1, BEST2 and SWEFOT3, have been proposed to identify early rheumatoid arthritis (ERA) patients at high risk of rapid radiographic progression (RRP), defined as an increase of the vdH-Sharp score ≥5 points at 1 year, despite initial treatment with methotrexate.
Objectives To test the validity of 3 RRP-prediction matrices in ERA patients from the ESPOIR cohort.
Methods The ESPOIR cohort included 813 patients with recent arthritis in ≤2 joints for ≤6 months. Patient data were collected every 6 months during the 2 first years of follow-up. Structural damage progression on X-rays was measured by the vdH-Sharp score. The capacity of the matrices to identify RRP patients at 1 year, was tested by Receiver Operation Curve (ROC) analysis in which the area under the curve (AUC) reflected the discriminating power.
Results 398 ESPOIR patients started MTX for ≥3 months during the 1st year. Their average characteristics were: age 49.3 y, female 74%, FR/ACPA+ 62%, RA erosion 18%, DAS28 5.35. The mean X-ray progression was 1.7 and 46 patients (11.6%) were classified RRP. The performance of the ASPIRE and SWEFOT matrices displayed only moderate validity, with AUC below 0.7. The BEST matrix seems to perform more optimally, with an AUC close to the ESPOIR matrix4, 0.79 vs. 0.75 (Figure).
Conclusions Tested in a different population of ERA patient, the BEST matrix seems to display good validity to identify patients at risk of RRP.
Vastesaeger et al, Rheumatology 2009.
Visser K et al, ARD 2010.
Saevarsdottir S, ACR 2011.
Fautrel B et al, ACR 2011.
Disclosure of Interest None Declared