Clinical course and outcome of early rheumatoid arthritis

We studied whether patients with seropositivity in early rheumatoid arthrit is (RA) comprise a different clinical group than those with seronegativity. Four hundred seventeen patients with early RA according to the American Co llege of Rheumatology criteria (disease duration less than 1 year) were ret rospectively studied by analysis of demographic, clinical, laboratory, radi ological, and therapeutic disease characteristics from the time of diagnosi s until the end of the study period (1981-1999) using a data base. There we re 248 seropositive patients and 169 seronegative patients with RA. No stat istically significant differences were seen between the two groups before c ommencement of the study period in relation to age of disease onset, male:f emale ratio, and disease duration. However, seropositive patients showed lo nger medical follow-up. In addition, at disease onset, seropositive RA pati ents presented more frequently with symmetrical polyarthritis and small joi nt involvement than seronegative patients. The seropositive group also had more tender and swollen joints, weaker grip strength, and higher erythrocyt e sedimentation and C-reactive protein rates during the follow-up period. I n contrast, the seronegative group had less severe radiological findings an d greater functional ability at the end of the study. In Greek patients wit h early RA, rheumatoid factor seems to be a predictor of more severe diseas e activity.