• Bernard Combe, Nathalie Rincheval, Joelle Benessiano, Francis Berenbaum, Alain Cantagrel, Jean-Pierre Daurès, Maxime Dougados, Patrice Fardellone, Bruno Fautrel, Rene M Flipo, Philippe Goupille, Francis Guillemin, Xavier Le Loët, Isabelle Logeart, Xavier Mariette, Olivier Meyer, Philippe Ravaud, Alain Saraux, Thierry Schaeverbeke, and Jean Sibilia.
• From the Lapeyronie Hospital, Montpellier I University, UMR 5535, EA2415, Montpellier; Paris-Bichat University Hospital, AP-HP; Paris St. Antoine University Hospital, Paris; Toulouse University Hospital, Toulouse; Paris-Descartes University; UPRES-EA 4058; Cochin Hospital, Paris; Amiens University Hospital, Amiens; Paris-Pitié Salpêtrière University Hospital, Paris; Lille University Hospital, Lille 2 University, Lille; Tours University Hospital, UMR CNRS 7292, University of Tours, Tours; Nancy University Hospital, Institut National de la Santé et de la Recherche Médicale (INSERM) CIE6, Nancy; INSERM U905, Institute for Research and Innovation in Biomedicine, Rouen University, Rouen; MSD Paris; Université Paris-Sud, AP-HP, Hôpitaux Universitaires Paris-Sud; INSERM U738, AP-HP, Hotel Dieu, Paris; Brest University Hospital, Brest; Bordeaux University Hospital, Bordeaux; and Strasbourg University Hospital, Strasbourg, France.
• J Rheumatol. 2013 Oct 1; 40 (10): 1650-7.

ObjectiveTo report the 5-year outcome of a large prospective cohort of patients with very early rheumatoid arthritis (RA), and to identify factors predictive of outcome.MethodsPatients were recruited if they had early arthritis of < 6 months' duration, had a high probability of developing RA, and had never been prescribed disease-modifying antirheumatic drugs (DMARD) or steroids. Logistic regression analysis was used to determine factors that predict outcome.ResultsWe included 813 patients from December 2002 to April 2005. Age was 48.1 ± 12.6 years, delay before referral 103.1 ± 52.4 days, 28-joint Disease Activity Score (DAS28) 5.1 ± 1.3, Health Assessment Questionnaire (HAQ) 1.0 ± 0.7; 45.8% and 38.7% had rheumatoid factor or antibodies to cyclic citrullinated peptide (anti-CCP), respectively; 22% had hand or foot erosions; 78.5% fulfilled the American College of Rheumatology/European League Against Rheumatism criteria for RA at baseline and 93.8% during followup. At 5 years, 573 patients were evaluated. The outcome was mild for most patients: disease activity (median DAS28 = 2.5) and HAQ disability (median 0.3) were well controlled over time; 50.6% achieved DAS28 remission and 64.7% low disease activity. Radiographic progression was low (2.9 Sharp unit/year) and only a few patients required joint surgery. Nevertheless, some patients developed new comorbidities. During the 5 years, 82.7% of patients had received at least 1 DMARD (methotrexate, 65.9%), 18.3% a biological DMARD, and about 60% prednisone at least once. Anti-CCP was the best predictor of remaining in the cohort for 5 years, of prescription of synthetic or biologic DMARD, and of radiographic progression.ConclusionThe 5-year outcome of an early RA cohort in the 2000s was described. Anti-CCP was a robust predictor of outcome. The generally good 5-year outcome could be related to early referral and early effective treatment, key processes in the management of early RA in daily practice.

30 keywords...

hide…