Background Structural impairment of large joints in patients with rheumatoid arthritis (RA) is strongly associated with functional disabilities. Although evaluation methods of large joint damage were limited, the ARASHI study group has recently devised new radiographic scoring system (Status score; range 0-16 points, and Change score: range -11 to 12 points) .
Objectives To evaluate the radiographic damage of 10 large joints (bilateral shoulder, elbow, hip, knee and ankle joints) in patients with RA using the ARASHI score, and to explore factors that predict the progression of large joint damage.
Methods We have prospectively examined 64 patients with RA. Radiographic findings of large joints (122 shoulder, 123 elbow, 120 hip, 98 knee, and 117 ankle joints), excluding the joints with history of surgical intervention, were evaluated at baseline using the ARASHI status score and at 1 year using the ARASHI change score. Total ARASHI status score and change score were calculated from scores of all 10 large joints in each patient. We measured CRP, MMP-3 DAS28-ESR, SDAI, CDAI and HAQ-DI at baseline and at 1 year, and then compared differences of these clinical features between total ARASHI change score <1 (non-progression) group and change score ≥1 (progression) group.
Results The mean total ARASHI status score of all 10 large joints in 64 patients was 8.70 (0-58) at baseline. The total ARASHI change score showed joint remodeling (change score ≤ -1) in 18 patients (28.1%) and progression of joint damage in 21 patients (32.8%) at 1 year. The age, disease duration, CRP, MMP-3, disease activity, HAQ-DI and total ARASHI status score at baseline were not significantly different between non-progression group and progression group. The CRP, disease activity and HAQ-DI at 1 year were also not significantly different in each group. However, the mean MMP-3 value at 1 year in progression group was significantly higher that in non-progression group (153.5 ng/ml vs 80.9 ng/ml, P <0.05).
Conclusions We evaluated the radiographic damage of all 10 large joints in each patient with RA using total ARASHI score. Our results showed that decrement of serum MMP-3 level was associated with the inhibition of large joint damage in RA.
Kaneko A, et al. Mod Rheumatol. 2013; 23; 1053-1062.
Disclosure of Interest None declared
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