PT  - JOURNAL ARTICLE
AU  - Visser, K
AU  - Goekoop-Ruiterman, Y P M
AU  - de Vries-Bouwstra, J K
AU  - Ronday, H K
AU  - Seys, P E H
AU  - Kerstens, P J S M
AU  - Huizinga, T W J
AU  - Dijkmans, B A C
AU  - Allaart, C F
TI  - A matrix risk model for the prediction of rapid radiographic progression in patients with rheumatoid arthritis receiving different dynamic treatment strategies: post hoc analyses from the BeSt study
AID  - 10.1136/ard.2009.121160
DP  - 2010 Jul 01
TA  - Annals of the Rheumatic Diseases
PG  - 1333--1337
VI  - 69
IP  - 7
4099  - http://ard.bmj.com/content/69/7/1333.short
4100  - http://ard.bmj.com/content/69/7/1333.full
SO  - Ann Rheum Dis2010 Jul 01; 69
AB  - Objectives To develop a matrix model for the prediction of rapid radiographic progression (RRP) in subpopulations of patients with recent-onset rheumatoid arthritis (RA) receiving different dynamic treatment strategies. Methods Data from 465 patients with recent-onset RA randomised to receive initial monotherapy or combination therapy were used. Predictors for RRP (increase in Sharp-van der Heijde score ≥5 after 1 year) were identified by multivariate logistic regression analysis. For subpopulations, the estimated risk of RRP per treatment group and the number needed to treat (NNT) were visualised in a matrix. Results The presence of autoantibodies, baseline C-reactive protein (CRP) level, erosion score and treatment group were significant independent predictors of RRP in the matrix. Combination therapy was associated with a markedly reduced risk of RRP. The positive and negative predictive values of the matrix were 62% and 91%, respectively. The NNT with initial combination therapy to prevent one patient from RRP with monotherapy was in the range 2–3, 3–7 and 7–25 for patients with a high, intermediate and low predicted risk, respectively. Conclusion The matrix model visualises the risk of RRP for subpopulations of patients with recent-onset RA if treated dynamically with initial monotherapy or combination therapy. Rheumatologists might use the matrix for weighing their initial treatment choice.