Radiological progression in early XXXX after DMARDS: a one-year follow-up study in a clinical setting.

@entity1 @entity13655 @entity227 @entity66 @entity2681 @entity16 @entity158 @entity1499 @entity309
OBJECTIVE: To analyse the frequency and prognostic factors of radiographic progression in a series of Spanish @entity1 with early @entity309 ( @entity309 ) after 1 yr of treatment with disease-modifying anti-rheumatic drugs (DMARDs). METHODS: Sixty @entity1 (47 females, 13 males) with @entity309 with a disease duration shorter than 2 yr [mean (s.d.) duration 9.5+/-6.6 months] were treated with the same therapeutic protocol using gold salts as the first DMARD and @entity1499 as a second option, and were followed up for 1 yr. Radiographic progression in the hands and feet (total radiographic Larsen score and the @entity2681 joint count) was used as the outcome variable. Clinical, laboratory, immunogenetic and radiographic data were obtained at study entry. Disease activity and response to therapy were measured at 6 and 12 months. RESULTS: @entity66 was found in 21.7% of @entity1 at baseline and in 38.3% after 1 yr. Although a substantial reduction in disease activity was observed during the 1 yr follow-up [disease activity score (DAS28) 5.8+/-0.8 at entry and 3.9+/-1.3 at 12 months, P < 0.001], the Larsen score rose from 1.9+/-3.3 to 5.6+/-9.8 after 1 yr. In 26.6% of @entity1 , a raised @entity2681 joint count was observed after 1 yr. Radiographic progression in the total joint radiographic damage (increase in Larsen score of >or=2) was observed in 36.6%. In the multivariate analysis, baseline @entity158 [visual analogue scale (VAS)] and the presence of two copies of the shared epitope were associated with radiographic progression in the @entity2681 joint count. Disease duration before study entry, @entity227 and Larsen score at baseline were significant predictors of radiographic progression in @entity16 (Larsen score). Baseline radiographic damage had the highest positive predictive value for progression. CONCLUSIONS: Radiographic progression was observed in up to 36.6% of @entity1 with early @entity309 after 1 yr of @entity13655 therapy in spite of a significant reduction in disease activity. Baseline factors, such as @entity227 , disease duration until DMARD therapy, damage score at baseline and the presence of two copies of the shared epitope, were associated with radiographic progression.
