The course of rheumatoid arthritis and predictors of psychological, physical and radiographic outcome after 5 years of follow-up

Objective. To examine the course of RA over 5 yr and identify predictors of psychological, physical and radiographic outcome. Patients and methods. Out of 238 patients with rheumatoid arthritis of no m ore than 4 (mean 2.2) yr duration, 182 (76%) completed a clinical examinati on with follow-up at 1, 2, and 5 yr. The course of the disease was assessed by measures of psychological and physical health status, disease process a nd radiographic damage. Results. Over 5 yr we observed at a group level a stable disease course For measures of disease process, psychological and physical health status. Rad iographic damage progressed. Health status and radiographic damage after 5 yr were predicted by the baseline measures for the respective outcome. Phys ical function was also predicted by age and by psychological status when th e physical dimension of the Arthritis Impact Measurement Scales was chosen as outcome variable. Erythrocyte sedimentation rate and presence of rheumat oid factor predicted radiographic progression. Conclusions. The 5 yr course of RA was characterized by preserved health st atus' measures and clinically preserved disease process measures, whereas j oint damage progressed steadily. Outcomes after 5 yr can be predicted partl y by certain measures at baseline.