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AB0327 Five-Year Clinical, Functional and Radiological Outcomes of Early Rheumatoid Arthritis
  1. Y.A. Ermakova1,
  2. D.E. Karateev1,
  3. E.L. Luchikhina1,
  4. N.V. Demidova1,
  5. A.V. Smirnov2,
  6. E.L. Nasonov1
  1. 1Department of Early Arthritis and the Prediction of Rheumatic Diseases
  2. 2V.A. Nasonova Research Institute of Rheumatology, Russian Federation, Moscow, Moscow, Russian Federation

Abstract

Background The study of the clinical course of rheumatoid arthritis (RA), it functional and radiological changes is especially important for a long time. These data give an understanding of the main outcomes of this disease.

Objectives To study the dynamics of disease activity, radiological course and the development of functional disorders in patients with early RA.

Methods We used the data of long-term Russian project “RADICAL” (Rheumatoid Arthritis: Diagnostic, Outcomes, Criterions, Aggressive Treatment). 200 patients with early RA (diagnosed for less than two year) according to American College of Rheumatology criteria included in the study from 2003 to 2007 (67,5% RF (+); 57% ACCP (+), 86,5% women, age of 49 [40-58]). Patients followed for 5 years. They were treated by DMARDs including the biologic therapy (24%) according the “tight-control” principle. The radiological investigation of hands and feet, DAS28, HAQ and functional class evaluated every 12 months.

Results With the passage of time have observed a decrease in the level of activity of RA. Baseline median [25th percentile, 75th percentile] DAS28 was 5,1 [4,49-5,85]. In the period from 1 to 5 years - 3,05 [2,25-4,43], 3,04 [2,07-4,23], 2,55 [1,86-3,74], 2,48 [1,78-3,77], 3,12 [1,86-4,32], respectively, p<0,01. The same trend applies to HAQ. Baseline median HAQ was 1,125 [0,625-1,75]. After 1, 2, 3, 4 and 5 years - 0,5 [0,125-1,0], 0,5 [0-1,0], 0,5 [0-1,0], 0,5 [0-1,0] and 0,75 [0,125-1,125], respectively, p<0,01. From 1 to 5 years the erosive arthritis was in 27,5%, 38,5%, 49,5%, 58%, 73% of cases, respectively, p<0,001. Baseline median of Sharp/van der Heijde erosions score was 0 [0-0]. After 1, 2, 3, 4 and 5 years it grew to 0 [0-1], 0 [0-4], 1 [0-8], 3 [0-12], 6 [0-14] respectively, p<0,01.

Conclusions During the first five years was noted stabilization of the RA. DAS28 and HAQ decrease. RA radiological progression was found, however the most of patients showed only minor deterioration of structural damage.

Disclosure of Interest None declared

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