Abstract

Background: Many studies have examined the relationship between long-term radiographic damage and physical function. However, it is not known if short-term radiographic progression is also associated with physical function.

Aim: To investigate the longitudinal relationship between physical function and both level of radiographic damage and radiographic progression rate in patients with early or advanced active rheumatoid arthritis (RA).

Methods: The database for the 2-yearTrial of Etanercept and Methotrexate with Radiographic Patient Outcomes (TEMPO) was used for this study. Physical function was measured by the Health Assessment Questionnaire (HAQ) score at baseline, 6 months, and 1 and 2 years. Radiographs of the hands and feet, taken at the same time points, were scored by the van der Heijde-modified Total Sharp Score (TSS). HAQ score was modelled using generalised mixed linear modelling by TSS or progression in TSS (interval 0-1 year and 1-2 years) adjusted for age, sex, treatment, and disease activity.

Results: After adjustment for age, sex, and disease activity, both TSS and the change in TSS (progression rate) were significant determinants of the HAQ score. When radiographic progression was divided into 4 categories (negative, zero, minor, and greater progression), results showed that HAQ scores tended to be higher with higher rate of progression. Patients with negative progression scores had lower HAQ scores compared with patients with positive progression scores.

Conclusions: Patients with greater radiographic damage, as well as those with recent radiographic progression, have a higher degree of disability.