PT  - JOURNAL ARTICLE
AU  - G Cohen
AU  - L Gossec
AU  - M Dougados
AU  - A Cantagrel
AU  - P Goupille
AU  - JP Daures
AU  - N Rincheval
AU  - B Combe
TI  - Radiological damage in patients with rheumatoid arthritis on sustained remission
AID  - 10.1136/ard.2006.057497
DP  - 2007 Mar 01
TA  - Annals of the Rheumatic Diseases
PG  - 358--363
VI  - 66
IP  - 3
4099  - http://ard.bmj.com/content/66/3/358.short
4100  - http://ard.bmj.com/content/66/3/358.full
SO  - Ann Rheum Dis2007 Mar 01; 66
AB  - Objective: To assess the radiological damage progression in patients with recent rheumatoid arthritis in sustained remission. Methods: A cohort of 191 patients with active early (<1 year) rheumatoid arthritis was prospectively assessed at baseline, 3 and 5 years by the Disease Activity Score (DAS) and the Sharp–van der Heijde Score (SHS) for radiographic damage. Patients in remission (DAS<1.6) at the 3-year and 5-year time points were compared with patients with a persistently active rheumatoid arthritis by Wilcoxon’s signed rank test. Results: 57 patients died, were lost to follow-up or had incomplete data; 30 (15.7% of those who completed) patients were in remission at 3 and 5 years. The SHS in these two groups was not significantly different at baseline (p = 0.15), but was lower in the remission group at 5 years (p = 0.0047). The median (IQR) radiographic score increased from 0.5 (0–7) at baseline to 2.5 (0–14) after 5 years for the remission group (p = 0.18) and from 2 (0–7) to 13 (3–29) in the group with active rheumatoid arthritis (p<0.001). 5 (16.7%) patients in remission had relevant progression of radiographic damage (ie, progression >4.1 points) and 6 (20%) presented new erosions in a previously unaffected joint between the third and the fifth years. Conclusion: Patients with early rheumatoid arthritis in sustained remission did not present statistically significant radiographic degradation at the group level; nevertheless, 16.7% of these patients did present degradation. Absence of progression should be part of the remission definition in rheumatoid arthritis.