Repair of Erosions in Patients with Rheumatoid Arthritis

J Rheumatol. 2019 Jul;46(7):670-675. doi: 10.3899/jrheum.180557. Epub 2019 Feb 1.

Abstract

Objective: The aim of this study was to examine the occurrence of repair in a cohort of conventionally treated patients with early rheumatoid arthritis over 8 years.

Methods: There were 395 patients included in the BARFOT study having radiographs of hands and feet at inclusion, and at 1, 2, 5, and 8 years, which were chronologically scored for erosions by the Sharp/van der Heijde method. An erosion with repair was defined as an erosion that has become partially or totally filled, with or without sclerosis.

Results: Erosions with repair were observed in 64 patients (16%) at 1 year, 113 (29%) at 2 years, 142 (36%) at 5 years, and 200 (51%) at 8 years. At the 1-year visit, 13% of the patients with at least 1 new erosion showed repair versus 3% of the patients with no new erosions (p = 0.001). At 2, 5, and 8 years the corresponding figures were 22% and 6%, 28% and 8%, and 39% and 11%, respectively (all p = 0.001). The sum of all repaired erosions correlated strongly with the sum of all erosions and with the sum of all erosion scores (ρ = 0.79 and 0.77). Presence of rheumatoid factor (RF) and anticyclic citrullinated peptide antibodies (anti-CCP) was significantly associated with both new erosions and repair.

Conclusion: Repair was more common than previously described. The frequency of repair increased over time and was associated with the number of erosions. RF- and anti-CCP-positivity, patient age, and presence of erosions at baseline were independent predictors of repair.

Keywords: DISEASE ACTIVITY; RADIOGRAPHY; REPAIR OF EROSIONS; RHEUMATOID ARTHRITIS; SHARP/VAN DER HEIJDE METHOD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Anti-Citrullinated Protein Antibodies / blood
  • Anti-Inflammatory Agents / therapeutic use*
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Rheumatoid / complications*
  • Bone Resorption / diagnostic imaging
  • Bone Resorption / drug therapy*
  • Bone Resorption / etiology*
  • Female
  • Follow-Up Studies
  • Foot / diagnostic imaging
  • Hand / diagnostic imaging
  • Humans
  • Male
  • Middle Aged
  • Prednisolone / therapeutic use*
  • Radiography
  • Rheumatoid Factor / blood
  • Treatment Outcome

Substances

  • Anti-Citrullinated Protein Antibodies
  • Anti-Inflammatory Agents
  • Antirheumatic Agents
  • Rheumatoid Factor
  • Prednisolone