Prediction of 20-year outcome at onset of seropositive rheumatoid arthritis

Objective With the advent of new and expensive antirheumatic treatments with potentia lly serious side effects, it would be essential to identify as early as pos sible those rheumatoid arthritis (RA) patients who have a poor prognosis. H ere study was made of the prognostic value of different markers recorded at the onset of RA. Methods At the 20-year follow-up of our prospective study, 66 patients had rheumato id factor-positive (RF+) RA. At commencement of follow-up (disease duration < 6 months), the prognostic value of 19 demographic, laboratory clinical a nd radiographic variables was tested to explain the 20-year Larsen score fo r peripheral joints and the Health Assessment Questionnaire (HAQ) index usi ng Somers' d for asymmetrical associations. Results An association was observed between onset blood platelets (0.17), serum IgG (0.18), the onset Larsen score (0.33) and the 20-year Larsen score. Old ag e (0.30), serum orosomucoid (0.17), the function score (0.28), morning stif fness (0.28), and grip strength (0.24) were associated with the 20-year HAQ . Conclusion The correlation between the investigated entry variables and end-point outc ome was poor. In our discussion we conclude that the most important prognos tic factor in RF+ RA is the treatment.