Prediction of radiographic progression of rheumatoid arthritis


Authors: K. Pavelka;  J. Gatterová
Authors‘ workplace: Revmatologický ústav Praha
Published in: Čes. Revmatol., 18, 2010, No. 1, p. 19-25.
Category: Overview Reports

Overview

Progression in structural changes in rheumatoid arthritis leads to a simultaneous decrease in functional abilities and the quality of life of a patient. Therefore it is of great importance to thoroughly evaluate the disease, and use such therapeutic approaches which lead to slowing or a complete cessation of radiographic progression. In the introduction, the authors discuss alternative methods of evaluation of structural progression of RA. The Sharp score (van der Heijde or Gennant modification) still represents the golden standard for the use in clinical randomised trials and observational studies. Furthermore, the authors present two models of risk evaluation of rapid radiographic progression (RRP). The borderline value for RRP was chosen as > 5 units of the Sharp score year. The first model was derived from ATTRACT and ASPIRE studies, and the second one evolved from the BeST study. It is a visual matrix model enabling an evaluation of an individual patient’s risk for RRP using a combination of various risk factors of progression. Based on the percentage value in the RRP risk, appropriate level of aggressive treatment is selected – including, for instance, an initial combination therapy with a biological agent in patients with a high RRP risk, and, on the contrary, a less intensive treatment with a synthetic DMARD monotherapy in patients with a lower risk. Persisting high activity, rheumatoid factors, anti-CCP antibodies or their combination, and high titers of acute phase reactants belong to the most significant risk factors for RRP. This proposed model will have to be tested in further prospective studies in various populations with RA.

Key words:
rheumatoid arthritis, rapid radiographic progression, Sharp score, anti-TNF therapy


Sources

1. Larsen A, Dale K, Eek M, et al. Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films. Acta Radiol (Diagn) 1977; 18: 481–491.

2. Sharp JT, Young DY, Bluhm GB, et al. How many joints in the hands and wrists should be included in a score of radiologic abnormalities used to asses rheumatoid arthritis. Ann Rheum Dis; 28: 1326–35.

3. Van der Heide D,van Riel P, et al. Biannual radiographic assessments of hands and feetin a free-year prospective follow up of patiens with early rheumatoid arthritis. Arthritis Rheum 1992; 35: 26–34.

4. Gennat HK, Jiang Y, Peterfy C, et al.Assesssment of rheumatoid arthritis using a modified scoring method on digitized and originál radiographs. Artrhritis Rheum 1998; 41: 1583–90.

5. Smolen JS, van der Heijde D, Aletaha D, et al. „Progression of radiographic joint damage in rheumatoid arthritis: Independence of erosions and joint space narrowing. Ann Rheum Dis 2008; doi:10.1136/ard.2008.094128.

6. Machold KP, Symmons TA. Very recent onset arthritis: clinical, laboratory and radiological findings during first year of disease. J. Rheumatol. 2002; 29: 2278–87.

7. Hulsmans HM, Jacobs JWG, nav der Heijde D, et al. The course of radiologic damage during the first six years of rheumatoid arthritis. Artrhritis Rheum 2000; 43: 1927–1940.

8. Graudal NA, Jurik AG, Carvalho A Radiographic progression in rheumatoid arthritis. Arthritis Rheum 1998; 41: 1470–1480.

9. Strand V. Using estimated yearly progression rates to campare radiographic data across recent randomised controlled trials in rheumatoid arthritis. Ann Rheum Dis 2002; 61(Suppl. II): ii64–ii66.

10. Pavelka K, Gatterová J, Tegzová D, et al. Radiographic progression of rheumatoid arthritis in patiens from the Czech National Registry receiving infliximab treatment. Clinical and Experimental Rheumatology 2007; 25: 540–545.

11. Welsing PMJ, Landewe RBM, van Riel PLCM, et al. The relationship between disease activity and radiologic progression in patiens with rheumatoid arthritis. Arthritis Rheum 2004; 50: 2082–2093.

12. Syversen SW, Gaarder PL, Goll GL, et al. High anti cyclic citrulinated peptide levels and a algorithm of baseline parameters can predict radiograpic progression in patiens with rheumatoid arthritis: results from a 10 year longitudinal study. Ann Rheum Dis 2008; 67: 212–217.

13. Lindquist E, Eberhardt K, Bendtzen K, et al. Prognostic laboratrory markers of joint damage in rheumatoid arthritis. Ann Rheum Dis 2005; 64: 196–201.

14. de Vries Boustra J, Cessie S, Allart C, et al. Using predicted disease outcome to provide differentiated treatment of early rheumatoid arthritis. J Rheumatol 2006; 33: 1747–1753.

15. Hetland ML, Ejbjerg B, Horslev Petersen K, et al. MRI bone oedema is the strongest predictor of subsequent radiographic progresssion in early rheumatoid arthritis. Results from a 2 year randnomised controlled trial. Ann Rheum Dis 2009; 68: 384–390.

16. Schmidt WA Technology Insight: the role of color and power Doppler ultrasonography in rheumatology. Nat Clin Pract Rheumatol 2007; 335–42.

17. Naredo E, Bonilla G, Gampero F, et al. Assessment of inflammatory aktivity in rheumatoid arthritis: a comparative study of clinical evaluation with grey scale and power Doppler ultrasonography. Ann Rheum Dis 2005; 64: 375–381.

18. Ostergaard M, Peterfy C, Conaghan P, et al. OMERACT rheumatoid arthritis magnetic resonance imaging studies. Core set of MRI acquisitions, joint patology definitions, and the OMERACT RA-MRI scoring systém. J Rheumatol 2003; 30: 1385–1386.

19. Jones B, Halbert J, Crotty, et al.The effect of treatment on radiological progression in rheumatoid arthritis: a systematic review of randomized contolled trials. Rheumatology 2003; 42: 6–13.

20. Korpela M, Leasonen L, Hannonen P, et al. Retardation of joint damage in patiens with early rheumatoid arthritis by initial aggressive treatment with disease modifying antirheumatic drugs: a five-year experience from FIN-RACO study. Arthritis Rheum 2004; 50: 2072–81.

21. Lipsky PE, van der Heide DM, St.Clair EW, et al. Infliximab and methotrexate therapy of rheumatoid arthritis. N Engl J Rheumatol 2000; 343: 1594–1602.

22. Klareskog, et al. TEMPO (Trial of Etanercept and Methotrexate with Radiographic Patient Outcomes) study investigator. Therapeutic efect of the combination of etanercept and methotrexate compared with each treatmetn alone in patients with rheumatoid arthritis: double-blind randomised controlled trial. Lancet 2004; 363: 675–81.

23. Keystone, et al. Radiographic, clinical and functional outcomes of treatment with adalimumab (a human anti-tumor necrosis factor monoclonal antibody) in patients with active placebo-controlled, 52-week trial. Arthritis Rheum 2004; 50: 1400–11.

24. Keystone EC, Genovese MC, Klareskog L. Golimumab, a human antibody to tumour necrosis factor (alpha) given by monthly subcutaneous injections, in active rheumatoid arthritis despite methotrexate therapy: the GO-FORWARD Study. Ann Rheum Dis 2009 Jun; 68(6): 789–96. Epub 2008 Dec 9.

25. Smolen JS, Keystone EC, Emery P, Breedveld FC. Consensus statement on the use of rituximab in patients with rheumatoid arthritis. Ann Rheum Dis 2007 Feb; 66(2):143–50. Epub 2006 Oct 26.

26. Weinblatt M, Combe B, Covucci A, Aranda R, et al. Safety of the selective costimulation modulator abatacept in rheumatoid arthritis patients receiving background biologic and nonbiologic disease-modifying antirheumatic drugs: A one-year randomized, placebo-controlled study. Arthritis Rheum 2006 Sep; 54(9): 2807–16.

27. Kremer JM, Fleischman RM, Halland AM: Tocilizumab inhibit structural damage in rheumatoid arthritis patiens with inadequate response to methotrexate. ACR 2008; Abstract L19.

28. St. Clair FW, van der Heide D, Smolen JS, et al. Combination of inliximab and methotrexate therapy for early rheumatoid arthritis: a randomized, controlled trial. Arthritis Rheum 2004; 50: 3432–43.

29. Emery P, et al. Comparison of methotrexate monotherapy with combination of MTX and etanercept in active early, moderate to severe rheumatoid arthritis (COMET): a randomized, double-blind, parallel treatment trial. Lancet, 2008; doi:10.1016/s140–6736(08)61000–4.

30. Jamal S, Kaushnik P, Keystone EC, et al. Adalimumab response in patiens with early versus established rheumatoid arthritis: DE 019 randomized, controlled trial subanalysis. Clin Rheumatol 2009; 28: 413–419.

31. Kirwan JR. The synovium in rheumatoid arthritis:evidence for (at least) two pathologies. Artrhritis Rheum 2004; 50: 1–4.

32. Vastesaeger N, Xu Stephen, Aletaha D, et al. A pilot risk model for the prediction of rapid radiographic progression in rheumatoid arthritis. Rheumatology 2009; doi:10.1093(rheumatology)kep 155.

33. Goekoop-Ruiterman YP, De Vries Boustra JK, Alaart CF, et al. Clinical and radiographic outcomes fo four different treatement strategies in patiens with early rehumatoid artrhritis the BeST study: a randomized, controlled, trial. Artrhitis Rheum 2005; 52: 3381–3390.

34. Visser K, Goekoop YPM- Ruiterman, De Vries Boustra JK, et al. A matrix model for prediction of rapid radiographic progression in rheumatoid arthritis patiens receiving different treatment strategies. Abstrakt EULAR 2009; Cobenhaven.

35. Visvanathan S, Marini JC, Smolen JC, et al. Changes in biomarkers of inflammation and bone turnover and associations with clinical efficacy following infliximab plus methotrexate therapy in poatients with early rehuamatoid arthritis. J Rheumatol 2007; 34: 1465–74.

36. van Zeben D, Hazes JM, Zwindeman AH, et al. Association of HLA- DR4 s více agresivním průběhem nemoci u pacientů s revmatoidní artritidou. Artrhritis Rheum 1991; 34: 822–30.

37. Nishimura K, Suplyyama D, Kogata Y, et al. Meta-analysis: diagtnostic accuracy of anticyclic citrulinated peptide and rheumatoid factor for rheumatoid arthritis. Ann Intern Med 2007; 146: 797–808.

Labels
Dermatology & STDs Paediatric rheumatology Rheumatology
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