%0 Journal Article %1 Kaltenhauser.2001 %A Kaltenhäuser, S. %A Wagner, U. %A Schuster, Ernst %A Wassmuth, R. %A Arnold, S. %A Seidel, W. %A Tröltzsch, M. %A Loeffler, Markus %A Häntzschel, H. %D 2001 %J The Journal of rheumatology %K IMISE-Publikationen %N 4 %P 735–744 %T Immunogenetic markers and seropositivity predict radiological progression in early rheumatoid arthritis independent of disease activity %V 28 %X OBJECTIVE A prospective clinical study of patients with recent onset rheumatoid arthritis (RA) to examine the relationship between inflammatory disease activity and joint destruction in a 4 year followup, and to evaluate prognostic markers for severe joint erosions early in the disease. METHODS Eighty-seven patients with RA according to the American College of Rheumatology criteria and a disease duration < 2 years were followed for an observation time of 2 to 4 years (mean 3.1 yrs). Variables of clinical and laboratory disease activity were monitored, and HLA-DRB1 alleles were determined. Hand and foot radiographs were taken every 6 months. RESULTS Multivariate analysis of independent contributions of covariates to progression of joint destruction resulted in a mixed effect regression model with significant influences for the presence of a shared epitope (SE) positive DR4 allele (SE+ DR4+; p = 0.007), rheumatoid factor (RF) IgA (p = 0.01), and sex (p = 0.059), but not for clinical variables or acute phase reactants. The odds ratio to reach a Larsen score above 32 during the observation period of 4 years was increased in patients positive for RF IgM (OR 2.7, p = 0.019), for the shared epitope on a DR4 allele (OR 8.6, p < 0.005), and in patients with erosions already at study entry (OR 11.9, p = 0.001). The highest sensitivity and specificity for the prediction of severe bone destruction (84\% and 79\%) were found when the presence of either a SE+ DR4 allele or of early erosions was used as a prognostic marker (OR 20.4, p < 0.0001). CONCLUSION Our results show the pace of joint destruction in RA to be influenced by the presence of SE+ DR4 alleles, RF production, and sex and by the presence of erosive disease at presentation. Those prognostic markers exert their influence independently from the inflammatory disease activity.

@article{Kaltenhauser.2001, abstract = {OBJECTIVE A prospective clinical study of patients with recent onset rheumatoid arthritis (RA) to examine the relationship between inflammatory disease activity and joint destruction in a 4 year followup, and to evaluate prognostic markers for severe joint erosions early in the disease. METHODS Eighty-seven patients with RA according to the American College of Rheumatology criteria and a disease duration < 2 years were followed for an observation time of 2 to 4 years (mean 3.1 yrs). Variables of clinical and laboratory disease activity were monitored, and HLA-DRB1 alleles were determined. Hand and foot radiographs were taken every 6 months. RESULTS Multivariate analysis of independent contributions of covariates to progression of joint destruction resulted in a mixed effect regression model with significant influences for the presence of a shared epitope (SE) positive DR4 allele (SE+ DR4+; p = 0.007), rheumatoid factor (RF) IgA (p = 0.01), and sex (p = 0.059), but not for clinical variables or acute phase reactants. The odds ratio to reach a Larsen score above 32 during the observation period of 4 years was increased in patients positive for RF IgM (OR 2.7, p = 0.019), for the shared epitope on a DR4 allele (OR 8.6, p < 0.005), and in patients with erosions already at study entry (OR 11.9, p = 0.001). The highest sensitivity and specificity for the prediction of severe bone destruction (84\% and 79\%) were found when the presence of either a SE+ DR4 allele or of early erosions was used as a prognostic marker (OR 20.4, p < 0.0001). CONCLUSION Our results show the pace of joint destruction in RA to be influenced by the presence of SE+ DR4 alleles, RF production, and sex and by the presence of erosive disease at presentation. Those prognostic markers exert their influence independently from the inflammatory disease activity.}, added-at = {2014-10-16T12:05:48.000+0200}, author = {Kaltenhäuser, S. and Wagner, U. and Schuster, Ernst and Wassmuth, R. and Arnold, S. and Seidel, W. and Tröltzsch, M. and Loeffler, Markus and Häntzschel, H.}, biburl = {https://www.bibsonomy.org/bibtex/20aa50a5997fef725a07a7362a3176da1/drtester}, interhash = {18ce2db9309bef4bd22ad4d9f5124267}, intrahash = {0aa50a5997fef725a07a7362a3176da1}, journal = {The Journal of rheumatology}, keywords = {IMISE-Publikationen}, number = 4, pages = {735–744}, timestamp = {2014-12-03T00:08:42.000+0100}, title = {Immunogenetic markers and seropositivity predict radiological progression in early rheumatoid arthritis independent of disease activity}, volume = 28, year = 2001 }