TY - JOUR T1 - Only high disease activity and positive rheumatoid factor indicate poor prognosis in patients with early rheumatoid arthritis treated with “sawtooth” strategy JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - 533 LP - 539 DO - 10.1136/ard.57.9.533 VL - 57 IS - 9 AU - T Möttönen AU - L Paimela AU - M Leirisalo-Repo AU - H Kautiainen AU - J Ilonen AU - P Hannonen Y1 - 1998/09/01 UR - http://ard.bmj.com/content/57/9/533.abstract N2 - OBJECTIVES To investigate the prognostic significance of clinical and genetic markers on the outcome of patients with recent-onset rheumatoid arthritis (RA) treated actively with slow acting antirheumatic drugs (SAARDs).METHODS A total of 142 consecutive patients with early RA (median disease duration of 7 months) were treated according to the “sawtooth” strategy and prospectively followed up for an average of 6.2 years. Several clinical parameters at start as well as genetic markers were related to the functional outcome (ARA Functional class and HAQ disability score) and radiographic joint damage (Larsen’s score) at the latest visit.RESULTS In logistic regression analysis only Mallya score (including morning stiffness, pain scale, grip strength, Ritchie’s articular index, haemoglobin, and erythrocyte sedimentation rate) at baseline, and Mallya score and rheumatoid factor (RF) positivity at one year were found to be of significance with respect to the radiographic outcome of the patients. Furthermore, at the latest visit HAQ score was related to radiographic score. At baseline the mean ages of the DR4 positive patients and the patients with RA associated DR alleles were statistically significantly lower than those without the above mentioned risk factors (44 v 49, p=0.03 and 41 v 53, p=0.04, respectively). However, these genetic markers had no prognostic significance on the functional or radiographic outcome of the patients.CONCLUSION High clinical disease activity at baseline and RF positivity especially at one year after the institution of SAARD treatment are the best predictors of poor prognosis in early RA. However, from the clinical point of view, the disease outcome of an individual patient with early RA, cannot be predicted accurately enough by present means. ER -