AB1379 PREDICTORS OF RADIOLOGICAL PROGRESSION IN PATIENTS WITH RHEUMATOID ARTHRITIS: A PROSPECTIVE OBSERVATION

Autor: O. Alekseeva, V. Rybakova, A. Smirnov, A. Volkov, E. Nasonov
Rok vydání: 2022
Předmět:
Zdroj: Annals of the Rheumatic Diseases. 81:1794.2-1795
ISSN: 1468-2060
0003-4967
DOI: 10.1136/annrheumdis-2022-eular.5083
Popis: Objectivesto identify the prognostic role of ultrasound signs (US) in radiologic progression in RA patientsMethods61 RA pts, mean age 50,0 [38,0; 59,0] yrs, mean disease duration 7 [4; 20] months were treated with MTX and biologics according to the Treat-To-Target concept. After first year of therapy management was following real clinical practice rules until the termination of the study (7 years FUP, median 7,7 [7,4;8,6]). Among them 40 patients with early RA, mean age 51,0 [43,0; 60,0], disease duration 5 [3; 6,5] months. The general characteristics of the group are presented in the Table 1. Hands and feet ultrasound (US) with grayscale (GS), power Doppler (PD), and destructive changes (erosion), according to the criteria of OMERACT, were analyzed before initiation of treatment and in 3, 6, 9, and 12 months after. Radiographs were obtained at baseline, at 12 months, 4 years, and 7 years, radiographic changes were assessed using Sharp/van der Heijde modified scoring method. Radiographic progression was documented based on Sharp/Van der Heijde modified score changes during the follow-up.Table 1.General characteristicsCharacteristicAt baselineAfter 7 years follow upMedian age, years50,0 [38,0; 59,0]Disease duration, months7 [4; 20]GS6 [4; 9]PD2 [1; 6]DAS 285,6 [4,8; 6,5]4,03 [3,42; 4,74]ESR, mm/h35,0 [13,0; 50,0]22,0 [14,0; 36,0]CRP, mg/l10,6 [3,8; 32,3]3,0 [1,2; 8,8]Rheumatoid Factor, positive results53 (87%)Anti-CPA, positive results52 (85%)Mean erosion score0 [0; 3]3 [1; 11]Mean joint-space narrowing score57,0 [31,0; 88,0]98,0 [77,0; 110,0]Modified total Sharp score70,0 [31,0; 88,0]102,0 [78,0; 117,0]Results52 ACPA+ (85%) and 9 ACPA− (15%) patients presented among the 61 patients with RA. RA progression by 4 years FUP was identified in 36% (22 p) of pts, by 7 years FUP was identified in 69% (42 p) of pts.During the 7 years FUP 42 of 61 patients had radiographic progression: the count of erosion increased from 0 [0; 3] to 3 [1; 11]. At the same time, on the background of therapy during the first year, a decrease in ultrasound signs of inflammation was determined according to the GS and PD: from 6 [4; 9] to 4 [2; 6] p = 0.000 and from 2 [1; 6] to 0 [0; 2] p = 0.000, respectively, and increase in the number of joints with erosions (from 1 [0; 2] to 2 [0; 3], p = 0.000).All pts divided into groups based increase in erosions according to radiography (Rg +) and without it (Rg-). In the group Rg + GS at baseline was significantly higher than in Rg- group (6 [5; 10] and 5 [1; 8], respectively, p=0.04). CRP at 3 months and at 6 months was significantly higher in RG+ group than in RG- group (4,15 [1,2; 8,7] and 1,2 [0; 3,5], respectively, p=0.03 and 2,35 [0,8; 10,1] and 0,4 [0; 4,3], respectively, p=0.025).ConclusionThus, we obtained the first data on the important prognostic role of ultrasound in assessing the progression of early RA in a prospective seven-year follow-up.Disclosure of InterestsNone declared
Databáze: OpenAIRE
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