AGALACTOSYL IGG [GAL(O)] - AN ANALYSIS OF ITS CLINICAL UTILITY IN THELONG-TERM FOLLOW-UP OF PATIENTS WITH RHEUMATOID-ARTHRITIS

This long-term prospective study of patients with newly diagnosed RA a ssesses the relative value of certain clinical and laboratory measures at first consultation in order to determine factors that help to disc riminate between patients like to go into early remission and those wi th relapsing/remiting or persistent disease. Validation was sought in a similar group from a separate but comparable prospective study. Meas ures of clinical activity such as joint score, early morning stiffness (EMS) and acute phase (ESR) improved over 4 yr in both groups, wherea s agalactosyl IgG [Gal(o)] levels increased. Using discriminant functi onal analysis in the first cohort to identify features at entry which would predict outcome at 4 yr, a combination of Gal(o), grip strength, age at onset and gender predicted the course of RA correctly in 95% o f the patients. This combination was confirmed in the second cohort, a lthough with reduced power (78% correct). Thus, we show that Gal(o) do es not reflect activity of the disease like the ESR, but has greater p otential as a prognostic index early in the course of disease.