AMYLOIDOSIS - INCIDENCE AND EARLY RISK-FACTORS IN PATIENTS WITH RHEUMATOID-ARTHRITIS

In a 15-year follow-up examination, reactive secondary amyloidosis (RS A) was found by subcutaneous fat biopsy in six out of 74 still living patients (8.1%) of an original population of 102 with erosive and sero positive rheumatoid arthritis (RA). Five of the 24 deceased patients h ad had RSA. Thus the 15-year incidence of RSA in RA was at least 10.9% (11/102). To study early prognostic aspects of RSA, comparison was ma de of 14 entry variables and the initial treatment in the RSA group (n = 11) and the control group (n = 81) respectively. At onset (less-tha n-or-equal-to 6 months) of RA only serum orosomucoid, but after three years morning stiffness, ESR. serum CRP and orosomucoid were significa ntly worse in patients whom later developed RSA. Three out of 48 patie nts treated with gold sodium thiomalate and seven out of 30 treated wi th chloroquine developed RSA (p = 0.04). It is concluded that continuo usly active disease was the risk factor underlying RSA. The role of ea rly chloroquine therapy is discussed.