PT  - JOURNAL ARTICLE
AU  - Sascha L Heckert
AU  - Sytske Anne Bergstra
AU  - Xanthe M E Matthijssen
AU  - Yvonne P M Goekoop-Ruiterman
AU  - Faouzia Fodili
AU  - Saskia ten Wolde
AU  - Cornelia F Allaart
AU  - Tom W J Huizinga
TI  - Joint inflammation tends to recur in the same joints during the rheumatoid arthritis disease course
AID  - 10.1136/annrheumdis-2021-220882
DP  - 2022 Feb 01
TA  - Annals of the Rheumatic Diseases
PG  - 169--174
VI  - 81
IP  - 2
4099  - http://ard.bmj.com/content/81/2/169.short
4100  - http://ard.bmj.com/content/81/2/169.full
SO  - Ann Rheum Dis2022 Feb 01; 81
AB  - Objectives We investigated whether local joint swelling recurs in the same joints over time in patients with rheumatoid arthritis (RA) who are treated to target.Methods Patients with newly diagnosed RA participating in the Behandel-Strategieën, “treatment strategies” (BeSt) study (n=508) were followed for median 10 years while receiving Disease Activity Score (DAS) ≤2.4 steered treatment. Every 3 months 68 joints were assessed for the presence of swelling. We evaluated whether baseline local joint swelling was predictive for swelling in the same joint during follow-up using a multilevel mixed-effect logistic regression model. Different strategies were used to account for missing data. A permutation test was performed to assess if joint swelling was better predicted by baseline swelling of the joint itself than by baseline swelling of randomly selected other joints.Results In 46% of the joints that were swollen at baseline, joint swelling later recurred at least once during follow-up. Joint swelling at baseline was statistically significantly associated with swelling in the same joint during follow-up (OR 2.37, 95% CI 2.30 to 2.43, p<0.001), and also specifically with recurrent swelling in the same joint (OR 1.73, 95% CI 1.37 to 1.59, p<0.001). Local joint swelling was better predicted by baseline swelling of that particular joint than by baseline swelling of other joints (p<0.001).Conclusion Joint swelling tends to recur locally in the joints swollen at RA onset. This suggests that local factors influence the manifestation of joint inflammation over time.Data are available upon reasonable request.