Article Text

FRI0513 Does non - erosive rheumatoid arthritis exist ?
  1. J. Amaya-Amaya1,
  2. E. Calvo-Páramo1,
  3. A. Calderon-Páez1,
  4. G. Torralvo-Morato1,
  5. O. J. Calixto1,
  6. R. D. Mantilla1,
  7. J. M. Anaya1,
  8. A. Rojas-Villarraga1
  1. 1Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia


Background Erosions are the hallmark of rheumatoid arthritis (RA). Although most of erosions may occur within 2 years of onset of the disease, their progression does not correlate with the duration of RA. Moreover, information about non-erosive RA is ambiguous.

Objectives To evaluate the prevalence and characteristics of non-erosive RA.

Methods Since no agreement about the time-lag interval for erosions appearance in RA exists, and there is no universally accepted definition about it, a zero score in hands and feet X-ray at 5 years of RA duration (by SvHD) was arbitrary considered as cut-off. Therefore, patients meeting these criteria were searched in a large cohort of RA patients (ACR, 1987). Metacarpophalangeal and metatarsophalangeal joints as well as wrist ultrasound (US) imaging (by OMERACT), and computed tomography (CT) were performed to confirm non-erosive RA. Spearman correlation coefficient, kappa analysis and Kendall´s W test were used to analyze data.

Results Out of a total of 800 RA patients, 38 met inclusion criteria (4.75%). Most of them were women (76.3%). The median (IQR) of the age and duration of the disease were 52 (13) and 10 (8) years, respectively. Rheumatoid factor (RF) and anti-CCP antibodies were positive in 86.8% and 55.3%, respectively. Non-erosive RA was confirmed by the three methods in only 7 patients. There was no concordance between the three methods. For this sample, the sensitivity and specificity were 70% and 52% for US, and 58% and 57% for CT, respectively. Non-erosive RA was positively although weakly correlated with improved functional class according to the HAQ (r=0.32, p=0.045) and ANA positivity (r=0.43, p=0.030), and negatively correlated with activity of the disease (by RAPID3, r= -0.32, p=0.05), the use of biological therapy (r= -0.31, p=0.05) and RF (r= -0.36, p=0.042).

Conclusions Non-erosive RA is rare (0.87%). A good functional class, ANA positivity, RAPID3 score, the use of biological therapy and RF influence the absence of erosions in long-standing RA (i.e., 5 years). Since there is a high variability and a lack of concordance exists among the imagining techniques, a consensus and unified definition about non-erosive RA are warranted.

Disclosure of Interest None Declared

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