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Season-associated environmental factors have been related to the onset of rheumatoid arthritis (RA) and the severity of joint complaints.1 ,2 A recent study demonstrated that the onset of arthritis symptoms during winter or spring was associated with more radiographic joint damage after 1 year.3 This led us to evaluate the influence of the season of symptom onset on long-term radiographic progression.
Six hundred and eighty-eight RA-patients, from the Leiden Early Arthritis Clinic (EAC) and 830 RA-patients from the Swedish BARFOT-study were included in the study.4 ,5 These cohorts were similar in the percentage of women patients, age, symptom duration, swollen joint count, C reactive protein and the percentage of anti-cyclic citrullinated protein antibody positive patients (data not shown). During a follow-up period of 5 and 7 years, a total of 6990 hands and feet x-ray sets were obtained and scored for joint damage according to the Sharp-van-der-Heijde method ( all …
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