TIME-LAG BETWEEN ACTIVE JOINT INFLAMMATION AND RADIOLOGICAL PROGRESSION IN PATIENTS WITH EARLY RHEUMATOID-ARTHRITIS

Objective. To determine clinical variables useful in predicting the pr ognosis of patients with early rheumatoid arthritis (RA) by investigat ing the relationship between clinical variables and radiological progr ession. Methods. One hundred eighteen patients with early RA whose sym ptoms developed within the previous year were enrolled in a prospectiv e study. Data from the 98 patients who completed the 2 year study were analyzed, using the number of erosive joints and Larsen's score as th e outcome of RA. Results. Increases in the number of erosive joints at 12 months after entry into the study were significantly correlated wi th the number of swollen joints (r = 0.510), erythrocyte sedimentation rate (ESR) (r = 0.404), and C-reactive protein (CRP) (r = 0.487) at 6 months. The same results were seen using Larsen's score as the measur e of outcome. The average number of erosive joints or mean Larsen's sc ore at 12 months was higher in patients whose levels of CRP were high at 6 months and suppressed by 12 months, but increased much less in pa tients whose levels of CRP were successfully suppressed by 6 months. M ore joint erosions were noted in patients with positive rheumatoid fac tor (RF) than in RF negative patients. Conclusion. Joint erosions appe ared with a certain time lag after active synovitis. Earlier introduct ion of effective treatment is recommended for the prevention of RA joi nt damage. The presence of RF, number of swollen joints, ESR, and leve ls of CRP at 6 months after starting therapy are the most useful varia bles to predict radiological progression in patients with early RA.