Reductions in radiographic progression in early RA over 25-years: changing contribution from RF in 2 multi-centre UK inception cohorts
Objectives: To assess 5-year progression of erosions and Joint Space Narrowing (JSN), and their associations with RF status in two large, multi-centre early-RA cohorts spanning 25-years. Methods: Radiographic joint damage was recorded using the Sharp/van der Heijde (SvdH) method in the Early RA S...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
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Wiley
2017
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| Online Access: | https://eprints.nottingham.ac.uk/41376/ |
| _version_ | 1848796261140922368 |
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| author | Carpenter, Lewis Norton, Sam Nikiphorou, Elena Jayakumar, Keeranur McWilliams, Daniel F. Rennie, Kirsten L. Dixey, Josh Kiely, Patrick D.W. Walsh, David A. Young, Adam |
| author_facet | Carpenter, Lewis Norton, Sam Nikiphorou, Elena Jayakumar, Keeranur McWilliams, Daniel F. Rennie, Kirsten L. Dixey, Josh Kiely, Patrick D.W. Walsh, David A. Young, Adam |
| author_sort | Carpenter, Lewis |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Objectives: To assess 5-year progression of erosions and Joint Space Narrowing (JSN), and their associations with RF status in two large, multi-centre early-RA cohorts spanning 25-years.
Methods: Radiographic joint damage was recorded using the Sharp/van der Heijde (SvdH) method in the Early RA Study (ERAS) 1986-2001, and the Early RA Network (ERAN) 2002-2013. Mixed-effects negative-binomial regression estimated changes in radiographic damage over 5-years, including erosions and JSN separately. Rheumatoid Factor (RF), along with age, sex and baseline markers of disease activity were controlled for.
Results: 1,216 patients from ERAS and 446 from ERAN had radiographic data. Compared to ERAS, ERAN patients had a lower mean total SvdH score at baseline (ERAN=6.2 vs. ERAS=10.5, p<0.001), and mean annual rate of change (ERAN=2.5 vs. ERAS=6.9 per year, p<0.001). 74% of ERAS and 27% of ERAN patients progressed ≥5 units. Lower scores at baseline in ERAN were largely driven by reductions in JSN (ERAS=3.9 vs. ERAN=1.2, p<0.001), along with erosions (ERAS=1.9 vs. ERAN=0.8, p<0.001). RF was associated with greater progression in each cohort, but the absolute difference in mean annual rate of change for RF positive patients was substantially higher for ERAS (RF+= 8.6 vs. RF-= 5.1, p<0.001), relative to ERAN (RF+= 2.0 vs. RF-= 1.9, p=0.855).
Conclusion: Radiographic progression has significantly reduced between the two cohorts, associated with lower baseline damage and other factors, including changes in early DMARD use. The impact of RF status as a prognostic marker of clinically meaningful change in radiographic progression has markedly diminished in the context of more modern treatment. This article is protected by copyright. All rights reserved. |
| first_indexed | 2025-11-14T19:45:10Z |
| format | Article |
| id | nottingham-41376 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:45:10Z |
| publishDate | 2017 |
| publisher | Wiley |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-413762024-08-15T15:31:21Z https://eprints.nottingham.ac.uk/41376/ Reductions in radiographic progression in early RA over 25-years: changing contribution from RF in 2 multi-centre UK inception cohorts Carpenter, Lewis Norton, Sam Nikiphorou, Elena Jayakumar, Keeranur McWilliams, Daniel F. Rennie, Kirsten L. Dixey, Josh Kiely, Patrick D.W. Walsh, David A. Young, Adam Objectives: To assess 5-year progression of erosions and Joint Space Narrowing (JSN), and their associations with RF status in two large, multi-centre early-RA cohorts spanning 25-years. Methods: Radiographic joint damage was recorded using the Sharp/van der Heijde (SvdH) method in the Early RA Study (ERAS) 1986-2001, and the Early RA Network (ERAN) 2002-2013. Mixed-effects negative-binomial regression estimated changes in radiographic damage over 5-years, including erosions and JSN separately. Rheumatoid Factor (RF), along with age, sex and baseline markers of disease activity were controlled for. Results: 1,216 patients from ERAS and 446 from ERAN had radiographic data. Compared to ERAS, ERAN patients had a lower mean total SvdH score at baseline (ERAN=6.2 vs. ERAS=10.5, p<0.001), and mean annual rate of change (ERAN=2.5 vs. ERAS=6.9 per year, p<0.001). 74% of ERAS and 27% of ERAN patients progressed ≥5 units. Lower scores at baseline in ERAN were largely driven by reductions in JSN (ERAS=3.9 vs. ERAN=1.2, p<0.001), along with erosions (ERAS=1.9 vs. ERAN=0.8, p<0.001). RF was associated with greater progression in each cohort, but the absolute difference in mean annual rate of change for RF positive patients was substantially higher for ERAS (RF+= 8.6 vs. RF-= 5.1, p<0.001), relative to ERAN (RF+= 2.0 vs. RF-= 1.9, p=0.855). Conclusion: Radiographic progression has significantly reduced between the two cohorts, associated with lower baseline damage and other factors, including changes in early DMARD use. The impact of RF status as a prognostic marker of clinically meaningful change in radiographic progression has markedly diminished in the context of more modern treatment. This article is protected by copyright. All rights reserved. Wiley 2017-12 Article PeerReviewed Carpenter, Lewis, Norton, Sam, Nikiphorou, Elena, Jayakumar, Keeranur, McWilliams, Daniel F., Rennie, Kirsten L., Dixey, Josh, Kiely, Patrick D.W., Walsh, David A. and Young, Adam (2017) Reductions in radiographic progression in early RA over 25-years: changing contribution from RF in 2 multi-centre UK inception cohorts. Arthritis Care & Research, 69 (12). pp. 1809-1817. ISSN 2151-4658 http://onlinelibrary.wiley.com/doi/10.1002/acr.23217/abstract doi:10.1002/acr.23217 doi:10.1002/acr.23217 |
| spellingShingle | Carpenter, Lewis Norton, Sam Nikiphorou, Elena Jayakumar, Keeranur McWilliams, Daniel F. Rennie, Kirsten L. Dixey, Josh Kiely, Patrick D.W. Walsh, David A. Young, Adam Reductions in radiographic progression in early RA over 25-years: changing contribution from RF in 2 multi-centre UK inception cohorts |
| title | Reductions in radiographic progression in early RA over 25-years: changing contribution from RF in 2 multi-centre UK inception cohorts |
| title_full | Reductions in radiographic progression in early RA over 25-years: changing contribution from RF in 2 multi-centre UK inception cohorts |
| title_fullStr | Reductions in radiographic progression in early RA over 25-years: changing contribution from RF in 2 multi-centre UK inception cohorts |
| title_full_unstemmed | Reductions in radiographic progression in early RA over 25-years: changing contribution from RF in 2 multi-centre UK inception cohorts |
| title_short | Reductions in radiographic progression in early RA over 25-years: changing contribution from RF in 2 multi-centre UK inception cohorts |
| title_sort | reductions in radiographic progression in early ra over 25-years: changing contribution from rf in 2 multi-centre uk inception cohorts |
| url | https://eprints.nottingham.ac.uk/41376/ https://eprints.nottingham.ac.uk/41376/ https://eprints.nottingham.ac.uk/41376/ |