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Ferreira RJO, Fautrel B, Saraux A, Gaujoux‐Viala C, Rat A, Guillemin F, Silva JAP, Dougados M, Gossec L. Patient Global Assessment of Disease Activity and Radiographic Progression in Early Arthritis: Three‐Year Results From the ESPOIR Cohort. Arthritis Care Res (Hoboken) 2021; 73:1300-1305. [DOI: 10.1002/acr.24237] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 04/21/2020] [Indexed: 01/17/2023]
Affiliation(s)
- Ricardo J. O. Ferreira
- Centro Hospitalar e Universitário de Coimbra and Nursing School of Coimbra (ESEnfC) Coimbra Portugal
| | - Bruno Fautrel
- Institut Pierre Louis d’Epidémiologie et de Santé Publique INSERM Sorbonne Université and AP‐HP Pitié Salpêtrière Hospital, and CRI IMIDIATE Clinical Research Network Paris France
| | - Alain Saraux
- CHU Brest and UMR1227, Lymphocytes B et Autoimmunité INSERM Université de Bretagne occidentale Brest France
| | | | - Anne‐Christine Rat
- EA 4360 APEMAC Université de Lorraine, Nancy, France, and CHU Caen Caen France
| | - Francis Guillemin
- EA 4360 APEMAC Université de Lorraine, and Inserm CIC 1433 Epidémiologie clinique CHRU de Brabois Nancy France
| | - José A. P. Silva
- Centro Hospitalar e Universitário de Coimbra and University of Coimbra Coimbra Portugal
| | - Maxime Dougados
- Paris Descartes University Hôpital Cochin Assistance Publique Hôpitaux de Paris, and INSERM (U1153), Paris, France: Clinical epidemiology and biostatistics PRES Sorbonne Paris‐Cité Paris France
| | - Laure Gossec
- Institut Pierre Louis d’Epidémiologie et de Santé Publique INSERM Sorbonne Université, and AP‐HP Pitié Salpêtrière Hospital Paris France
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Végh E, Gaál J, Géher P, Gömöri E, Kovács A, Kovács L, Nagy K, Posta EF, Tamási L, Tóth E, Varga E, Domján A, Szekanecz Z, Szűcs G. Assessing the risk of rapid radiographic progression in Hungarian rheumatoid arthritis patients. BMC Musculoskelet Disord 2021; 22:325. [PMID: 33794855 PMCID: PMC8017697 DOI: 10.1186/s12891-021-04192-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/23/2021] [Indexed: 12/17/2022] Open
Abstract
Background The outcome of rheumatoid arthritis (RA) should be determined early. Rapid radiological progression (RRP) is > or = 5 units increase according to the van der Heijde-Sharp score within a year. The risk of RRP can be estimated by a matrix model using non-radiographic indicators, such as C-reactive protein (CRP), rheumatoid factor (RF) and swollen joint count (SJC). Patients and methods A non-interventional, cross-sectional, retrospective study was conducted in eleven Hungarian arthritis centres. We assessed RRP risk in biologic-naïve RA patients with the prevalence of high RRP risk as primary endpoint. RRP was calculated according to this matrix model. As a secondary endpoint, we compared RRP in methotrexate (MTX) responders vs non-responders. Results We analyzed data from 1356 patients. Mean CRP was 17.7 mg/l, RF was 139.3 IU/ml, mean 28-joint disease activity score (DAS28) was 5.00 and mean SJC was 6.56. Altogether 18.2% of patients had high risk (≥40%) of RRP. RA patients with high RRP risk of RRP (n = 247) had significantly lower age compared to those with RRP < 40% (n = 1109). MTX non-response (OR: 16.84), male gender (OR: 1.67), erosions at baseline (OR: 1.50) and ACPA seropositivity (OR: 2.18) were independent predictors of high-risk RRP. Male gender (OR: 5.20), ACPA seropositivity (OR: 4.67) and erosions (OR: 7.98) were independent predictors of high RRP risk in MTX responders. Conclusions In this Hungarian study, high RRP risk occurred in 18% of RA patients. These patients differ from others in various parameters. RRP was associated with non-response to MTX.
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Affiliation(s)
- Edit Végh
- Department of Rheumatology, University of Debrecen, Faculty of Medicine, Nagyerdei str 98, Debrecen, 4032, Hungary
| | - János Gaál
- Department of Rheumatology, University of Debrecen Kenézy Teaching Hospital, Debrecen, Hungary
| | - Pál Géher
- Department of Rheumatology and Immunology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Edina Gömöri
- Department of Rheumatology, Pándy Hospital, Gyula, Hungary.,Department of Rheumatology, Aladár Petz Hospital, Győr, Hungary
| | - Attila Kovács
- Department of Rheumatology, Hospital of State Railways, Szolnok, Hungary.,Semmelweis Hospital, Kiskunhalas, Hungary
| | - László Kovács
- Department of Rheumatology and Immunology, University of Szeged, Faculty of Medicine, Szeged, Hungary
| | - Katalin Nagy
- Department of Rheumatology, Ferenc Markhot Hospital, Eger, Hungary
| | - Edit Feketéné Posta
- Department of Rheumatology, University of Debrecen, Faculty of Medicine, Nagyerdei str 98, Debrecen, 4032, Hungary.,Department of Rheumatology, András Jósa Hospital, Nyiregyháza, Hungary
| | - László Tamási
- Department of Rheumatology, Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital, Miskolc, Hungary
| | - Edit Tóth
- Department of Rheumatology, Ferenc Flór Hospital, Kistarcsa, Hungary
| | - Eszter Varga
- Department of Rheumatology, Markusovszky Hospital, Szombathely, Hungary
| | - Andrea Domján
- Department of Rheumatology, University of Debrecen, Faculty of Medicine, Nagyerdei str 98, Debrecen, 4032, Hungary
| | - Zoltán Szekanecz
- Department of Rheumatology, University of Debrecen, Faculty of Medicine, Nagyerdei str 98, Debrecen, 4032, Hungary.
| | - Gabriella Szűcs
- Department of Rheumatology, University of Debrecen, Faculty of Medicine, Nagyerdei str 98, Debrecen, 4032, Hungary
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3
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Rydell E, Forslind K, Nilsson JÅ, Karlsson M, Åkesson KE, Jacobsson LTH, Turesson C. Predictors of radiographic erosion and joint space narrowing progression in patients with early rheumatoid arthritis: a cohort study. Arthritis Res Ther 2021; 23:27. [PMID: 33446222 PMCID: PMC7809738 DOI: 10.1186/s13075-020-02413-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 12/29/2020] [Indexed: 11/15/2022] Open
Abstract
Background Radiographic damage in rheumatoid arthritis (RA) includes erosions and joint space narrowing (JSN). Different mechanisms may underlie their development. The objective of this study was to evaluate predictors of these entities separately. Methods Consecutive early RA patients (symptom duration ≤12 months) from a defined area (Malmö, Sweden) recruited during 1995–2005 were investigated. Radiographs of hands and feet were scored by a trained reader according to the modified Sharp-van der Heijde score. Fat mass and lean mass distribution were measured at baseline using dual energy x-ray absorptiometry. Potential predictors of erosion and JSN progression from inclusion to the 5-year follow-up were evaluated. Results Two hundred and thirty-three patients were included. Radiographs at baseline and 5 years were available for 162 patients. The median (interquartile) progression of erosion and JSN scores were 4 (0–8) and 8 (1–16), respectively. Rheumatoid factor (RF) was a robust significant predictor of both erosion and JSN score progression. In adjusted analyses, anti-CCP antibodies predicted erosions while the erythrocyte sedimentation rate was predictive of both outcomes. Smoking and high baseline disease activity (DAS28 > 5.1) predicted progression of erosions. Baseline erosion score was associated with progression of both erosion and JSN progression, while baseline JSN score was predictive only of the progression of JSN. Overweight/obesity (BMI ≥ 25 kg/m2) was a significant negative predictor of JSN score progression (β = − 0.14, p = 0.018, adjusted for RF, age, baseline JSN score) also when additionally adjusting for ever smoking (p = 0.041). Among female patients, this effect was observed in those of estimated post-menopausal age (> 51 years), but not in younger women. The truncal to peripheral fat ratio was associated with less JSN score progression in women, but not in men. Conclusions Overweight RA patients had less JSN progression, independent of smoking status. This effect was seen in particular among older women (mainly post-menopausal), but not younger. Truncal fat was associated with less JSN progression in female patients. Smoking predicted erosion progression, and erosions may precede JSN. BMI and fat distribution may influence cartilage damage in early RA and might be related to hormonal factors.
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Affiliation(s)
- Emil Rydell
- Rheumatology, Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 1B, SE-205 02, Malmö, Sweden. .,Department of Rheumatology, Skåne University Hospital, Malmö, Sweden.
| | - Kristina Forslind
- Rheumatology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.,Spenshult Research and Development Centre, Halmstad, Sweden
| | - Jan-Åke Nilsson
- Rheumatology, Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 1B, SE-205 02, Malmö, Sweden.,Department of Rheumatology, Skåne University Hospital, Malmö, Sweden
| | - Magnus Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.,Department of Orthopaedics, Skåne University Hospital, Malmö, Sweden
| | - Kristina E Åkesson
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.,Department of Orthopaedics, Skåne University Hospital, Malmö, Sweden
| | - Lennart T H Jacobsson
- Rheumatology, Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 1B, SE-205 02, Malmö, Sweden.,Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at Gothenburg University, Göteborg, Sweden
| | - Carl Turesson
- Rheumatology, Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 1B, SE-205 02, Malmö, Sweden.,Department of Rheumatology, Skåne University Hospital, Malmö, Sweden
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4
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Carvajal Alegria G, Milin M, Gandjbakhch F, Saraux A, Bailly F, Jousse-Joulin S, Schaeverbeke T, Lukas C, Foltz V, Fautrel B, Devauchelle-Pensec V. A simplified radiographic score effectively predicts radiographic progression of early arthritis in a large nationwide French cohort. Rheumatology (Oxford) 2020; 59:1566-1573. [PMID: 31628807 DOI: 10.1093/rheumatology/kez450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 09/01/2019] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Evaluating radiographic progression is a key component of the follow-up of patients with RA. Existing scores are ill-suited to everyday clinical practice. The objective here was to validate a new simplified radiographic score (SRS) for evaluating radiographic progression in patients with early arthritis. METHODS Patients with arthritis of <6 months' duration were included in the large, prospective, nationwide, French ESPOIR cohort. Radiographs of the hands and feet were obtained at inclusion then 1 and 5 years later. The modified Sharp scores and SRS were determined by blinded readers. Interobserver reliability and intraobserver repeatability of each score, as well as agreement between the two scores, were assessed by computing the intraclass correlation coefficients. The rates of progression over the first year and the next 4 years were determined. RESULTS The 506 patients with complete data for the first 5 years were included. At inclusion, the intraclass correlation coefficient between the two scores was good for erosions (0.715, P < 0.001), joint space narrowing (0.892, P < 0.001) and the total score (0.896, P < 0.001). Agreement between the two scores was also good for radiographic progression after 1 year (0.781, P < 0.001). The SRS had good positive and negative predictive values for slow and for rapid progression. SRS determination was less time consuming. CONCLUSION The SRS is effective for monitoring radiographic progression in early arthritis and is easier to use and less time-consuming than the Sharp score. The usefulness of the SRS in clinical practice deserves further evaluation.
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Affiliation(s)
- Guillermo Carvajal Alegria
- UMR1227, Lymphocytes B et Autoimmunité, Université de Brest, Inserm, LabEx IGO, Brest.,Rheumatology Department, Cavale Blanche Hospital, Brest
| | - Morgane Milin
- Rheumatology Department, Hôpital Yves Le Foll, Saint-Brieuc
| | - Frédérique Gandjbakhch
- Sorbonne Université, UMR S 1136, Institut Pierre Louis d'Epidémiologie et Santé publique, Paris.,APHP, Pitié Salpêtrière Hospital, Rheumatology Department Unit, Paris
| | - Alain Saraux
- UMR1227, Lymphocytes B et Autoimmunité, Université de Brest, Inserm, LabEx IGO, Brest.,Rheumatology Department, Cavale Blanche Hospital, Brest
| | - Florian Bailly
- Sorbonne University, Paris.,Pitié Salpêtrière Hospital, APHP, Pain Unit, Paris
| | - Sandrine Jousse-Joulin
- UMR1227, Lymphocytes B et Autoimmunité, Université de Brest, Inserm, LabEx IGO, Brest.,Rheumatology Department, Cavale Blanche Hospital, Brest
| | | | - Cédric Lukas
- Rheumatology Department, Montpellier University, Montpellier Hospital and EA2415, Montpellier, France
| | - Violaine Foltz
- Sorbonne Université, UMR S 1136, Institut Pierre Louis d'Epidémiologie et Santé publique, Paris.,APHP, Pitié Salpêtrière Hospital, Rheumatology Department Unit, Paris
| | - Bruno Fautrel
- Sorbonne Université, UMR S 1136, Institut Pierre Louis d'Epidémiologie et Santé publique, Paris.,APHP, Pitié Salpêtrière Hospital, Rheumatology Department Unit, Paris
| | - Valérie Devauchelle-Pensec
- UMR1227, Lymphocytes B et Autoimmunité, Université de Brest, Inserm, LabEx IGO, Brest.,Rheumatology Department, Cavale Blanche Hospital, Brest
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5
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Guellec D, Cozien S, Ruyssen-Witrand A, Dieudé P, Saraux A. Prevalence and clinical significance of extra-articular manifestations at diagnosis in the ESPOIR cohort with recent-onset arthritis. Semin Arthritis Rheum 2020; 50:409-413. [DOI: 10.1016/j.semarthrit.2020.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 01/13/2020] [Accepted: 01/21/2020] [Indexed: 12/22/2022]
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6
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Vanier A, Smolen JS, Allaart CF, Van Vollenhoven R, Verschueren P, Vastesaeger N, Saevarsdottir S, Visser K, Aletaha D, Combe B, Fautrel B. An updated matrix to predict rapid radiographic progression of early rheumatoid arthritis patients: pooled analyses from several databases. Rheumatology (Oxford) 2019; 59:1842-1852. [DOI: 10.1093/rheumatology/kez542] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 09/19/2019] [Indexed: 01/23/2023] Open
Abstract
Abstract
Objective
In early RA, some patients exhibit rapid radiographic progression (RRP) after one year, associated with poor functional prognosis. Matrices predicting this risk have been proposed, lacking precision or inadequately calibrated. We developed a matrix to predict RRP with high precision and adequate calibration.
Methods
Post-hoc analysis by pooling individual data from cohorts (ESPOIR and Leuven cohorts) and clinical trials (ASPIRE, BeSt and SWEFOT trials). Adult DMARD-naïve patients with active early RA for which the first therapeutic strategy after inclusion was to prescribe methotrexate or leflunomide were included. A logistic regression model to predict RRP was built. The best model was selected by 10-fold stratified cross-validation by maximizing the Area Under the Curve. Calibration and discriminatory power of the model were checked. The probabilities of RRP for each combination of levels of baseline characteristics were estimated.
Results
1306 patients were pooled. 20.6% exhibited RRP. Four predictors were retained: rheumatoid factor positivity, presence of at least one RA erosion on X-rays, CRP > 30mg/l, number of swollen joints. The matrix estimates RRP probability for 36 combinations of level of baseline characteristics with a greatly enhanced precision compared with previously published matrices (95% CI: from ± 0.02 minimum to ± 0.08 maximum) and model calibration is excellent (P = 0.79).
Conclusion
A matrix proposing RRP probability with high precision and excellent calibration in early RA was built. Although the matrix has moderate sensitivity and specificity, it is easily usable and may help physicians and patients to make treatment decisions in daily clinical practice.
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Affiliation(s)
- Antoine Vanier
- Department of Biostatistics Public Health and Medical Informatics, Sorbonne University, APHP, University Hospitals Pitié-Salpêtrière Charles-Foix, Paris
- University Bretagne-Loire, University of Nantes, University of Tours, Inserm UMR U1246 SPHERE ‘Methods in patient-centered outcomes and health research’, Nantes
| | - Josef S Smolen
- Division of Rheumatology and Department of Medicine 3, University of Vienna, Vienna, Austria
| | - Cornelia F Allaart
- Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Ronald Van Vollenhoven
- Rheumatology Unit, Department of Medicine, Karolinska Institute and Karolinska University Hospital, Solna, Stockholm, Sweden
| | | | | | - Saedis Saevarsdottir
- Rheumatology Unit, Department of Medicine, Karolinska Institute and Karolinska University Hospital, Solna, Stockholm, Sweden
| | - Karen Visser
- Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Daniel Aletaha
- Division of Rheumatology and Department of Medicine 3, University of Vienna, Vienna, Austria
| | - Bernard Combe
- Department of Rheumatology, Montpellier 1 University, Montpellier University Hospital
| | - Bruno Fautrel
- Department of Rheumatology, Sorbonne University, GRC-08 (EEMOIS), APHP, University Hospitals Pitié-Salpêtrière Charles-Foix, Paris, France
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7
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Rydholm M, Wikström I, Hagel S, Jacobsson LTH, Turesson C. The Relation Between Disease Activity, Patient-Reported Outcomes, and Grip Force Over Time in Early Rheumatoid Arthritis. ACR Open Rheumatol 2019; 1:507-515. [PMID: 31777832 PMCID: PMC6857997 DOI: 10.1002/acr2.11062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 07/08/2019] [Indexed: 12/28/2022] Open
Abstract
Objective The objective of this study is to identify early predictors of future reduced grip force in patients with rheumatoid arthritis (RA) and to identify early predictors of grip force over time. Methods In a structured follow‐up of an inception cohort of patients with early RA, average grip force values of the dominant hand were evaluated and compared with the expected based on age‐ and sex‐specific reference values. Potential predictors of reduced grip force (less than 50% of expected) at 5 years were examined using logistic regression. Differences in percentage of expected grip force values over the study period and differences in change over time, by baseline disease parameters, were estimated using mixed linear‐effects models. Results Among 200 patients with early RA, 44% had reduced grip force 5 years after diagnosis. Baseline characteristics that predicted reduced grip force at 5 years included high scores for the Health Assessment Questionnaire Disability Index (odds ratio 1.54 per SD; 95% confidence interval 1.13‐2.11), high scores for pain and patient global assessment, and low grip force. C‐reactive protein levels, the erythrocyte sedimentation rate, the 28‐joint Disease Activity Score (DAS28), rheumatoid factor, anti–cyclic citrullinated peptide antibodies, joint counts, and synovitis of individual joints in the dominant upper extremity did not predict reduced grip force. Patients with baseline synovitis of the wrist or metacarpophalangeal joints or patients with a high DAS28 had lower estimated grip force at inclusion but also greater improvement of grip force over time. Conclusion Patient‐reported outcomes predicted reduced grip strength 5 years after diagnosis. This underlines the prognostic importance of disability in early RA. Joint counts and synovitis in individual joints may change rapidly in early RA and appear to be less predictive of long‐term hand function.
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Affiliation(s)
- Maria Rydholm
- Lund University and Skåne University Hospital, Malmö, Sweden
| | | | - Sofia Hagel
- Lund University and Skåne University Hospital, Lund, Sweden
| | - Lennart T H Jacobsson
- Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden, and Lund University, Malmö, Sweden
| | - Carl Turesson
- Lund University and Skåne University Hospital, Malmö, Sweden
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Archer R, Hock E, Hamilton J, Stevens J, Essat M, Poku E, Clowes M, Pandor A, Stevenson M. Assessing prognosis and prediction of treatment response in early rheumatoid arthritis: systematic reviews. Health Technol Assess 2019; 22:1-294. [PMID: 30501821 DOI: 10.3310/hta22660] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Rheumatoid arthritis (RA) is a chronic, debilitating disease associated with reduced quality of life and substantial costs. It is unclear which tests and assessment tools allow the best assessment of prognosis in people with early RA and whether or not variables predict the response of patients to different drug treatments. OBJECTIVE To systematically review evidence on the use of selected tests and assessment tools in patients with early RA (1) in the evaluation of a prognosis (review 1) and (2) as predictive markers of treatment response (review 2). DATA SOURCES Electronic databases (e.g. MEDLINE, EMBASE, The Cochrane Library, Web of Science Conference Proceedings; searched to September 2016), registers, key websites, hand-searching of reference lists of included studies and key systematic reviews and contact with experts. STUDY SELECTION Review 1 - primary studies on the development, external validation and impact of clinical prediction models for selected outcomes in adult early RA patients. Review 2 - primary studies on the interaction between selected baseline covariates and treatment (conventional and biological disease-modifying antirheumatic drugs) on salient outcomes in adult early RA patients. RESULTS Review 1 - 22 model development studies and one combined model development/external validation study reporting 39 clinical prediction models were included. Five external validation studies evaluating eight clinical prediction models for radiographic joint damage were also included. c-statistics from internal validation ranged from 0.63 to 0.87 for radiographic progression (different definitions, six studies) and 0.78 to 0.82 for the Health Assessment Questionnaire (HAQ). Predictive performance in external validations varied considerably. Three models [(1) Active controlled Study of Patients receiving Infliximab for the treatment of Rheumatoid arthritis of Early onset (ASPIRE) C-reactive protein (ASPIRE CRP), (2) ASPIRE erythrocyte sedimentation rate (ASPIRE ESR) and (3) Behandelings Strategie (BeSt)] were externally validated using the same outcome definition in more than one population. Results of the random-effects meta-analysis suggested substantial uncertainty in the expected predictive performance of models in a new sample of patients. Review 2 - 12 studies were identified. Covariates examined included anti-citrullinated protein/peptide anti-body (ACPA) status, smoking status, erosions, rheumatoid factor status, C-reactive protein level, erythrocyte sedimentation rate, swollen joint count (SJC), body mass index and vascularity of synovium on power Doppler ultrasound (PDUS). Outcomes examined included erosions/radiographic progression, disease activity, physical function and Disease Activity Score-28 remission. There was statistical evidence to suggest that ACPA status, SJC and PDUS status at baseline may be treatment effect modifiers, but not necessarily that they are prognostic of response for all treatments. Most of the results were subject to considerable uncertainty and were not statistically significant. LIMITATIONS The meta-analysis in review 1 was limited by the availability of only a small number of external validation studies. Studies rarely investigated the interaction between predictors and treatment. SUGGESTED RESEARCH PRIORITIES Collaborative research (including the use of individual participant data) is needed to further develop and externally validate the clinical prediction models. The clinical prediction models should be validated with respect to individual treatments. Future assessments of treatment by covariate interactions should follow good statistical practice. CONCLUSIONS Review 1 - uncertainty remains over the optimal prediction model(s) for use in clinical practice. Review 2 - in general, there was insufficient evidence that the effect of treatment depended on baseline characteristics. STUDY REGISTRATION This study is registered as PROSPERO CRD42016042402. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Rachel Archer
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Emma Hock
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Jean Hamilton
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - John Stevens
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Munira Essat
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Edith Poku
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Mark Clowes
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Abdullah Pandor
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Matt Stevenson
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
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Chetina EV, Markova GA. [Upcoming value of gene expression analysis in rheumatology]. BIOMEDIT︠S︡INSKAI︠A︡ KHIMII︠A︡ 2018; 64:221-232. [PMID: 29964257 DOI: 10.18097/pbmc20186403221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disease of unknown etiology, which involves disturbance in immune system signaling pathway functions, damage of other tissues, pain and joint destruction. Modern treatment attempts to improve pathophysiological and biochemical mechanisms damaged by the disease. However, due to the RA patient heterogeneity personalized approach to treatment is required; the choice of personalized treatment is complicated by the variability of patient's response to treatment. Gene expression analysis might serve a tool for the disease control and therapy personification for inhibition of inflammation and pain as well as for prevention of joint destruction.
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Affiliation(s)
- E V Chetina
- Nasonova Research Institute of Rheumatology, Moscow, Russia
| | - G A Markova
- Nasonova Research Institute of Rheumatology, Moscow, Russia
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10
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Rydell E, Forslind K, Nilsson JÅ, Jacobsson LTH, Turesson C. Smoking, body mass index, disease activity, and the risk of rapid radiographic progression in patients with early rheumatoid arthritis. Arthritis Res Ther 2018; 20:82. [PMID: 29720260 PMCID: PMC5932864 DOI: 10.1186/s13075-018-1575-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 03/22/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Identification of risk factors for rapid joint destruction in early rheumatoid arthritis (RA) can be helpful for optimizing treatment, and improving our understanding of destructive arthritis and its mechanisms. The objective of this study was to investigate the relationship between early RA patient characteristics and subsequent rapid radiographic progression (RRP). METHODS An inception cohort of patients with early RA (symptom duration < 12 months), recruited during 1995-2005 from a defined area (Malmö, Sweden), was investigated. Radiographs of the hands and feet were scored in chronological order according to the modified Sharp-van der Heijde score (SHS), by a trained reader. RRP was defined as an increase of ≥ 5 points in SHS per year. RESULTS Two hundred and thirty-three patients were included. Radiographs were available from 216 patients at baseline, 206 patients at 1 year, and 171 patients at 5 years. Thirty-six patients (22%) had RRP up to 5 years. In logistic regression models, rheumatoid factor (RF) and anti-cyclic citrullinated peptides (anti-CCP), and increased erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) at baseline, predicted RRP over 5 years. Patients identified as overweight or obese had a significantly reduced risk of RRP up to 5 years (odds ratio (OR) 0.26; 95% confidence interval (CI) 0.11-0.63; adjusted for RF, baseline erosions, and ESR). Similar point estimates were obtained when stratifying for antibody status, and in models adjusted for smoking. A history of ever smoking was associated with a significantly increased risk of RRP up to 5 years, independent of body mass index (BMI) (OR 3.17; 95% CI 1.22-8.28; adjusted for BMI). At the 1-year follow-up, erosive changes, Disease Activity Score of 28 joints, Health Assessment Questionnaire, swollen joint count, and patient's global assessment of disease activity and pain were also significantly associated with RRP up to 5 years. CONCLUSIONS A history of smoking, presence of RF and/or anti-CCP and early erosions, high initial disease activity and active disease at 1 year, all increase the risk of RRP. Patients with a high BMI may have a reduced risk of severe joint damage. This pattern was not explained by differences in disease activity or antibody status. The results of this study suggest independent effects of smoking and BMI on the risk of RRP.
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Affiliation(s)
- Emil Rydell
- Rheumatology, Department of Clinical Sciences, Malmö, Lund University, Jan Waldenströms gata 35, SE-202 13, Malmö, Sweden. .,Department of Rheumatology, Skåne University Hospital, Inga Marie Nilssons gata 32, SE-214 28, Malmö, Sweden.
| | - Kristina Forslind
- Department of Research and Education, Helsingborg Hospital, Charlotte Yhlens gata 10, SE-251 87, Helsingborg, Sweden.,Rheumatology, Department of Clinical Sciences, Helsingborg, Lund University, Svartbrödragränden 3-5, SE-251 87, Helsingborg, Sweden
| | - Jan-Åke Nilsson
- Rheumatology, Department of Clinical Sciences, Malmö, Lund University, Jan Waldenströms gata 35, SE-202 13, Malmö, Sweden.,Department of Rheumatology, Skåne University Hospital, Inga Marie Nilssons gata 32, SE-214 28, Malmö, Sweden
| | - Lennart T H Jacobsson
- Rheumatology, Department of Clinical Sciences, Malmö, Lund University, Jan Waldenströms gata 35, SE-202 13, Malmö, Sweden.,Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at Gothenburg University, Guldhedsgatan 10 A, SE-405 30, Göteborg, Sweden
| | - Carl Turesson
- Rheumatology, Department of Clinical Sciences, Malmö, Lund University, Jan Waldenströms gata 35, SE-202 13, Malmö, Sweden.,Department of Rheumatology, Skåne University Hospital, Inga Marie Nilssons gata 32, SE-214 28, Malmö, Sweden
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11
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Tchetina E, Markova G. The clinical utility of gene expression examination in rheumatology. Mediterr J Rheumatol 2017; 28:116-126. [PMID: 32185269 PMCID: PMC7046055 DOI: 10.31138/mjr.28.3.116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 05/24/2017] [Indexed: 01/09/2023] Open
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disease with unknown etiology that affects various pathways within the immune system, involves many other tissues and is associated with pain and joint destruction. Current treatments fail to address pathophysiological and biochemical mechanisms involved in joint degeneration and the induction of pain. Moreover, RA patients are extremely heterogeneous and require specific treatments, the choice of which is complicated by the fact that not all patients equally respond to therapy. Gene expression analysis offer tools for patient management and personalization of patient’s care to meet individual needs in controlling inflammation and pain and delaying joint destruction.
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Affiliation(s)
- Elena Tchetina
- Immunology and Molecular Biology Laboratory, Nasonova Research Institute of Rheumatology, Moscow, Russia
| | - Galina Markova
- Immunology and Molecular Biology Laboratory, Nasonova Research Institute of Rheumatology, Moscow, Russia
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12
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Hua C, Daien CI, Combe B, Landewe R. Diagnosis, prognosis and classification of early arthritis: results of a systematic review informing the 2016 update of the EULAR recommendations for the management of early arthritis. RMD Open 2017; 3:e000406. [PMID: 28155923 PMCID: PMC5237764 DOI: 10.1136/rmdopen-2016-000406] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 12/11/2016] [Accepted: 12/12/2016] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE To update the evidence pertaining to the diagnosis, prognosis and classification of patients with early arthritis (EA), and to inform the 2016 European League Against Rheumatism (EULAR) recommendations for the management of patients with EA. METHODS MEDLINE, EMBASE and Cochrane databases were searched up to October 2015. The first part of the systematic literature review (SLR) involved a search for studies investigating the recognition and referral of EA. The second part involved a search for studies to identify the place of laboratory and imaging tests in establishing a diagnosis and a prognosis in patients with EA. RESULTS Regarding the issue of referral of patients with EA (1643 hits), 4 studies were included. These studies were in support of early referral for patients with EA. Regarding the issue of diagnosis and prognosis of patients with EA (11 435 hits), 88 studies were included, evaluating mainly the value of rheumatoid factor (RF) and anticitrullinated-peptide antibodies (ACPAs). Sensitivity of these antibodies for a RA diagnosis in patients with EA was moderate (40-80%). Specificity was higher, notably for ACPAs (frequently >80%). ACPAs also showed better prognostic performance than RF (negative predictive values around 80%). We confirmed that structural damage on baseline X-rays is predictive of further radiographic progression in patients with EA. Regarding other imaging modalities, data are sparse. CONCLUSIONS This SLR highlights the importance of early referral for patients with EA and confirms that RF and mainly ACPAs as well as a search for structural X-rays changes may help in the diagnosis and prognosis of patients with EA.
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Affiliation(s)
- Charlotte Hua
- Rheumatology Department , Lapeyronie Hospital, Montpellier University , Montpellier , France
| | - Claire I Daien
- Rheumatology Department , Lapeyronie Hospital, Montpellier University , Montpellier , France
| | - Bernard Combe
- Rheumatology Department , Lapeyronie Hospital, Montpellier University , Montpellier , France
| | - Robert Landewe
- Department of Clinical Immunology & Rheumatology , Amsterdam Rheumatology Center, Amsterdam and Zuyderland Medical Centre , Heerlen , The Netherlands
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13
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Gandjbakhch F, Granger B, Freund R, Foltz V, Jousse-Joulin S, Devauchelle V, Afshar M, Albert JD, Bailly F, Constant E, Biale L, Milin M, Couderc M, Denarie D, Fradin A, Martaille V, Pierreisnard A, Poursac N, Saraux A, Fautrel B. Multireader assessment as an alternative to reference assessment to improve the detection of radiographic progression in a large longitudinal cohort of rheumatoid arthritis (ESPOIR). RMD Open 2017; 3:e000343. [PMID: 28123779 PMCID: PMC5237761 DOI: 10.1136/rmdopen-2016-000343] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 11/29/2016] [Accepted: 11/30/2016] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Structural damage progression is a major outcome in rheumatoid arthritis (RA). Its evaluation and follow-up in trials should involve radiographic scoring by 1 or 2 readers (reference assessment), which is challenging in large longitudinal cohorts with multiple assessments. OBJECTIVES To compare the reproducibility of multireader and reference assessment to improve the feasibility of detecting radiographic progression in a large cohort of patients with early arthritis (ESPOIR). METHODS We used 3 sessions to train 12 rheumatologists in radiographic scoring by the van der Heijde-modified Sharp score (SHS). Multireader scoring was based on 10 trained-reader assessments, each reader scoring a random sample of 1/5 of all available radiographs (for double scoring for each X-ray set) for patients included in the ESPOIR cohort with complete radiographic data at M0 and M60. Reference scoring was performed by 2 experienced readers. Scoring was performed blindly to clinical data, with radiographs in chronological order. We compared multireader and reference assessments by intraclass correlation coefficients (ICCs) for SHS and significant radiographic progression (SRP). RESULTS The intrareader and inter-reader reproducibility for trained assessors increased during the training sessions (ICC 0.79 to 0.94 and 0.76 to 0.92), respectively. For the 524 patients included, agreement between multireader and reference assessment of SHS progression between M0 and M60 and SRP assessment were almost perfect, ICC (0.88 (95% CI 0.82 to 0.93)) and (0.99 (95% CI 0.99 to 0.99)), respectively. CONCLUSIONS Multireader assessment of radiographic structural damage progression is comparable to reference assessment and could be used to improve the feasibility of radiographic scoring in large longitudinal cohort with numerous X-ray evaluations.
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Affiliation(s)
- Frederique Gandjbakhch
- Department of Rheumatology, APHP, CHU Pitie-Salpetriere, Paris, France; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Benjamin Granger
- Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health, Paris, France; Department of Statistics, CHU Pitie Salpetriere, APHP, Paris, France
| | - Romain Freund
- Department of Rheumatology, APHP, CHU Pitie-Salpetriere, Paris, France; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Violaine Foltz
- Department of Rheumatology, APHP, CHU Pitie-Salpetriere, Paris, France; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | | | | | - Mona Afshar
- Department of Rheumatology , Hopital Jean Verdier , Bondy , France
| | | | - Florian Bailly
- Department of Rheumatology, APHP, CHU Pitie-Salpetriere, Paris, France; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Elodie Constant
- Department of Rheumatology , CHU Saint Etienne , Saint Etienne , France
| | - Lisa Biale
- Department of Rheumatology , Hopital Begin , Saint Mande , France
| | - Morgane Milin
- Department of Rheumatology , CHU la Cavale Blanche , Brest , France
| | - Marion Couderc
- Department of Rheumatology , CHU Clermont Ferrand , Clermont Ferrand , France
| | - Delphine Denarie
- Department of Rheumatology , CHU Saint Etienne , Saint Etienne , France
| | - Anne Fradin
- Department of Rheumatology , CHU Poitiers , Poitiers , France
| | | | - Audrey Pierreisnard
- Department of Rheumatology, APHP, CHU Pitie-Salpetriere, Paris, France; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Nicolas Poursac
- Department of Rheumatology , CHU Bordeaux , Bordeaux , France
| | - Alain Saraux
- Department of Rheumatology , CHU la Cavale Blanche , Brest , France
| | - Bruno Fautrel
- Department of Rheumatology, APHP, CHU Pitie-Salpetriere, Paris, France; Paris 6 University, GRC-UPMC 08, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
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14
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Granger B, Combe B, Le Loet X, Saraux A, Guillemin F, Fautrel B. Performance of matrices developed to identify patients with early rheumatoid arthritis with rapid radiographic progression despite methotrexate therapy: an external validation study based on the ESPOIR cohort data. RMD Open 2016; 2:e000245. [PMID: 27252898 PMCID: PMC4879338 DOI: 10.1136/rmdopen-2016-000245] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 03/07/2016] [Accepted: 04/16/2016] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Use of prediction matrices of risk or rapid radiographic progression (RRP) for early rheumatoid arthritis (RA) in clinical practice could help to better rationalise the first line of treatment. Before use, they must be validated in populations that have not participated in their construction. The main objective is to use the ESPOIR cohort to validate the performance of 3 matrices (ASPIRE, BEST and SONORA) to predict patients at high risk of RRP at 1 year of disease despite initial treatment with methotrexate (MTX). METHODS We selected from the ESPOIR cohort 370 patients receiving MTX or leflunomide (LEF) for ≥3 months within the first year of follow-up. Patients were assessed clinically every 6 months, and structural damage progression seen on radiography was measured by the van der Heijde-modified Sharp score (vSHS) at 1 year. RRP was defined as an increase in the vSHS≥5 points during the first year. RESULTS At 1 year, the mean vSHS score was 1.7±5.0 and 46 patients had RRP. The ASPIRE matrix had only moderate validity in the ESPOIR population, with area under the receiver operating characteristic curve (AUC) <0.7. The AUC for the BEST and SONORA matrices were 0.73 and 0.76. Presence of rheumatoid factor (RF)-or anti-citrullinated protein antibodies (ACPAs) and initial structural damage were always predictive of RRP at 1 year. Disease Activity Score in 28 joints (DAS28) and C reactive protein (ASPIRE threshold) were not associated with RRP. CONCLUSIONS Matrices to identify patients at risk of RRP tested in the ESPOIR cohort seem to perform moderately. There is no matrix that shows clearly superior performance.
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Affiliation(s)
- Benjamin Granger
- Université Pierre et Marie Curie (UPMC)—Paris 6, GRC 08, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
- Department of Biostatistics, Public Health and Medical Information, AP-HP Pitié Salpêtrière Hospital, Paris, France
| | - Bernard Combe
- Department of Rheumatology, Montpellier I University; Lapeyronie Hospital, Montpellier, France
| | - Xavier Le Loet
- Rheumatology Department, Rouen University Hospital & INSERM U905, Institute for Research and Innovation in Biomedicine, Rouen University, Rouen, France
| | - Alain Saraux
- Department of Rheumatology, Brest University, La Cavale Blanche University Hospital, Brest, France
- INSERM ESPRI, ERI29 Université Bretagne Occidentale, Brest, France
| | - Francis Guillemin
- EA 4360 APEMAC, Lorraine University, Paris-Descartes University, Nancy, France
- Faculty of Medicine, CS 50184, 54505 Vandoeuvre-lès-Nancy & Inserm, CIC-EC, CHU de Brabois, 54505 Vandoeuvre-lès-Nancy, Nancy, France
| | - Bruno Fautrel
- Université Pierre et Marie Curie (UPMC)—Paris 6, GRC 08, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
- Department of Rheumatology, Pitié Salpêtrière Hospital, Paris, France
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15
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Gärtner M, Sigmund IK, Alasti F, Supp G, Radner H, Machold K, Smolen JS, Aletaha D. Clinical joint inactivity predicts structural stability in patients with established rheumatoid arthritis. RMD Open 2016; 2:e000241. [PMID: 27110386 PMCID: PMC4838760 DOI: 10.1136/rmdopen-2016-000241] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 02/09/2016] [Accepted: 02/20/2016] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Clinical joint activity is a strong predictor of joint damage in rheumatoid arthritis (RA), but progression of damage might increase despite clinical inactivity of the respective joint (silent progression). The aim of this study was to evaluate the prevalence of silent joint progression, but particularly on the patient level and to investigate the duration of clinical inactivity as a marker for non-progression on the joint level. METHODS 279 patients with RA with any radiographic progression over an observational period of 3-5 years were included. We obtained radiographic and clinical data of 22 hand/finger joints over a period of at least 3 years. Prevalence of silent progression and associations of clinical joint activity and radiographic progression were evaluated. RESULTS 120 (43.0%) of the patients showed radiographic progression in at least one of their joints without any signs of clinical activity in that respective joint. In only 7 (5.8%) patients, such silent joint progression would go undetected, as the remainder had other joints with clinical activity, either with (n=84; 70.0%) or without (n=29; 24.2%) accompanying radiographic progression. Also, the risk of silent progression decreases with duration of clinical activity. CONCLUSIONS Silent progression of a joint without accompanying apparent clinical activity in any other joint of a patient was very rare, and would therefore be most likely detected by the assessment of the patient. Thus, full clinical remission is an excellent marker of structural stability in patients with RA, and the maintenance of this state reduces the risk of progression even further.
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Affiliation(s)
- M Gärtner
- Department of Rheumatology, Department of Medicine III , Medical University of Vienna , Vienna , Austria
| | - I K Sigmund
- Department of Rheumatology, Department of Medicine III , Medical University of Vienna , Vienna , Austria
| | - F Alasti
- Department of Rheumatology, Department of Medicine III , Medical University of Vienna , Vienna , Austria
| | - G Supp
- Department of Rheumatology, Department of Medicine III , Medical University of Vienna , Vienna , Austria
| | - H Radner
- Department of Rheumatology, Department of Medicine III , Medical University of Vienna , Vienna , Austria
| | - K Machold
- Department of Rheumatology, Department of Medicine III , Medical University of Vienna , Vienna , Austria
| | - J S Smolen
- Department of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria; 2nd Department of Medicine, Hietzing Hospital, Vienna, Austria
| | - D Aletaha
- Department of Rheumatology, Department of Medicine III , Medical University of Vienna , Vienna , Austria
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16
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Effect of age at rheumatoid arthritis onset on clinical, radiographic, and functional outcomes: The ESPOIR cohort. Joint Bone Spine 2016; 83:511-5. [PMID: 26992954 DOI: 10.1016/j.jbspin.2015.09.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Accepted: 09/09/2015] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To investigate whether age at disease onset determines clinical, radiographic or functional outcomes in a cohort of early RA. METHODS The ESPOIR cohort is a multicenter cohort of patients with early arthritis. We selected patients fulfilling the 2010 ACR/EULAR criteria for RA during the first 3years of follow-up. Patients were pooled into 3 groups by age at RA onset: <45years (young-onset RA [YORA]), 45 to 60years (intermediate-onset RA [IORA]) and>60years (late-onset RA [LORA]). The following outcomes were compared at baseline and during the first 3years of follow-up: Simple Disease Activity Index (SDAI) remission rate, one additional erosion, Health Assessment Questionnaire Disability Index (HAQ-DI)<0.5 and first disease-modifying anti-rheumatic drug (DMARD) continuation rate. RESULTS We included 698 patients (median [interquartile range] age 50.3 [39.8-57.2]years), 266 YORA, 314 IORA, and 118 LORA. At 1year, SDAI remission was greater for YORA than IORA and LORA (P<0.0001). Having at least one additional erosion was greater for LORA and IORA than YORA after 1year (P=0.009) and 3years (P=0.017). The proportion of patients with HAQ score<0.5 was greater for YORA than IORA and LORA at 1 (P=0.007), 2 and 3years. First DMARD continuation rate was lower for YORA than other groups during the 3years (P=0.005). CONCLUSIONS In a cohort of early RA, young age at disease onset is associated with high rate of remission at 1year, no radiographic progression at 3years and low functional score during 3-year follow-up.
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17
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Cornillet M, Ajana S, Ruyssen-Witrand A, Constantin A, Degboé Y, Cantagrel A, Meyer O, Serre G, Nogueira L. Autoantibodies to human citrullinated fibrinogen and their subfamilies to the α36-50Cit and β60-74Cit fibrin peptides similarly predict radiographic damages: a prospective study in the French ESPOIR cohort of very early arthritides. Rheumatology (Oxford) 2016; 55:1859-1870. [PMID: 26961744 DOI: 10.1093/rheumatology/kew014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate whether subfamilies of the RA-specific autoantibodies to human citrullinated fibrinogen (AhFibA) differentially associate with the RA risk factors, HLA-DRB1 shared epitope containing alleles (SE alleles) and cigarette smoking, and thus help to predict the disease outcome. METHODS AhFibA and their anti-α36-50Cit and anti-β60-74Cit subfamilies were assayed by ELISA, at baseline, in the French ESPOIR (Etude et Suivi des Polyarthrites Indifférenciées Récentes) cohort composed of undifferentiated arthritides and RA patients of < 6 months' duration. Cigarette smoking, SE alleles' presence, DAS28, HAQ and modified Sharp-van der Heijde Score data were obtained at baseline, and after follow-up. RESULTS After 3 years, 701 patients were classified as having RA according to the ACR/EULAR 2010 criteria. Among them, 349 (50%), 203 (29%) and 257 (37%) were AhFibA-, anti-α36-50Cit- and anti-β60-74Cit-positive, respectively. The presence and titres of AhFibA and their subfamilies similarly associated with SE alleles, irrespective of their fine specificity, without significant effect of smoking. Neither their presence nor their titre was associated with DAS28 or HAQ. The presence of at least one subfamily was associated with a faster Sharp/van der Heijde score progression, albeit without correlation with the titre. CONCLUSION AhFibA and their main subfamilies are similarly associated with SE alleles without additional effect of smoking. Whatever their fine specificity was, their presence (but not their titre) similarly constituted a marker of faster joint destruction.
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Affiliation(s)
- Martin Cornillet
- Laboratory of "Epidermis Differentiation and Rheumatoid Autoimmunity", UMR CNRS 5165, INSERM U 1056, Toulouse University, Laboratory of Cell Biology and Cytology, University Hospital of Toulouse
| | - Soufiane Ajana
- Laboratory of "Epidermis Differentiation and Rheumatoid Autoimmunity", UMR CNRS 5165, INSERM U 1056, Toulouse University
| | | | | | - Yannick Degboé
- Rheumatology Centre, University Hospital of Toulouse, Toulouse and
| | - Alain Cantagrel
- Rheumatology Centre, University Hospital of Toulouse, Toulouse and
| | - Olivier Meyer
- Rheumatology Centre APHP, Bichat Hospital, Paris, France
| | - Guy Serre
- Laboratory of "Epidermis Differentiation and Rheumatoid Autoimmunity", UMR CNRS 5165, INSERM U 1056, Toulouse University, Laboratory of Cell Biology and Cytology, University Hospital of Toulouse
| | - Leonor Nogueira
- Laboratory of "Epidermis Differentiation and Rheumatoid Autoimmunity", UMR CNRS 5165, INSERM U 1056, Toulouse University, Laboratory of Cell Biology and Cytology, University Hospital of Toulouse,
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Seror R, Boudaoud S, Pavy S, Nocturne G, Schaeverbeke T, Saraux A, Chanson P, Gottenberg JE, Devauchelle-Pensec V, Tobón GJ, Mariette X, Miceli-Richard C. Increased Dickkopf-1 in Recent-onset Rheumatoid Arthritis is a New Biomarker of Structural Severity. Data from the ESPOIR Cohort. Sci Rep 2016; 6:18421. [PMID: 26785768 PMCID: PMC4726234 DOI: 10.1038/srep18421] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 11/18/2015] [Indexed: 12/13/2022] Open
Abstract
Rheumatoid arthritis (RA) is the most common chronic inflammatory rheumatic condition over the world. RA is potentially disabling because chronic inflammation of the joints leads to joint destruction. To date, the best predictor of radiographic progression for patients with early RA is the presence of radiographic erosions at baseline, but a limited number of predictive biomarkers of structural progression are currently used in daily practice. Here, we investigated Dickkopf-1 (DKK-1) and sclerostin (SOST) serum levels in patients with recent inflammatory arthritis from the ESPOIR cohort. This cohort is a prospective, multicenter French cohort of 813 patients with early arthritis. We observed that mean baseline DKK-1 level was higher among RA patients with than without radiological progression within the first 2 years of evolution. DKK-1 level was still associated with radiographic progression in a model including other main predictors of severity (erosions at baseline, and anti-CCP antibody positivity). This study demonstrates that increased DKK-1 level at baseline predicted structural progression after 2-year follow-up and suggests that DKK-1 might be a new structural biomarker for early RA.
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Affiliation(s)
- Raphaèle Seror
- Service de Rhumatologie-Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, France.,Unité INSERM U1012 - Université Paris Sud, Le Kremlin Bicêtre, France
| | - Saida Boudaoud
- Unité INSERM U1012 - Université Paris Sud, Le Kremlin Bicêtre, France
| | - Stephan Pavy
- Service de Rhumatologie-Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, France
| | - Gaetane Nocturne
- Service de Rhumatologie-Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, France.,Unité INSERM U1012 - Université Paris Sud, Le Kremlin Bicêtre, France
| | | | | | - Philippe Chanson
- Assistance-Publique- Hôpitaux de Paris, Service d'Endocrinologie et des Maladies de la Reproduction, - Hôpitaux Universitaires Paris Sud, F-94275, Le Kremlin Bicêtre, France.,Univ Paris-Sud, UMR S693, F-94276, Le Kremlin Bicêtre, France
| | - Jacques-Eric Gottenberg
- Service de Rhumatologie, Centre National de Référence pour les Maladies Auto-Immunes Systémiques Rares, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | | | | | - Xavier Mariette
- Service de Rhumatologie-Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, France.,Unité INSERM U1012 - Université Paris Sud, Le Kremlin Bicêtre, France
| | - Corinne Miceli-Richard
- Service de Rhumatologie-Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, France.,Unité INSERM U1012 - Université Paris Sud, Le Kremlin Bicêtre, France
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Hamamoto Y, Ito H, Furu M, Hashimoto M, Fujii T, Ishikawa M, Yamakawa N, Terao C, Azukizawa M, Iwata T, Mimori T, Matsuda S. Serological and Progression Differences of Joint Destruction in the Wrist and the Feet in Rheumatoid Arthritis - A Cross-Sectional Cohort Study. PLoS One 2015; 10:e0136611. [PMID: 26317770 PMCID: PMC4552680 DOI: 10.1371/journal.pone.0136611] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 08/06/2015] [Indexed: 12/04/2022] Open
Abstract
Objective To investigate clinical and radiological differences between joint destruction in the wrist and the feet in patients with RA. Methods A cross-sectional clinical study was conducted in an RA cohort at a single institution. Clinical data included age, sex and duration of disease. Laboratory data included sero-positivity for anti-cyclic citrullinated peptide (CCP) antibody and RF. Radiological measurements included Larsen grades and the modified Sharp/van der Heijde method (SHS) for the hands/wrists and the feet. Statistical analyses were performed using the Kruskal—Wallis H-test, a dummy variable linear regression model and multivariate logistic regression analysis with 95% confidence interval and odds ratios. Results A total of 405 patients were enrolled, and 314 patients were analysed in this study. The duration of disease in the foot-dominant group was significantly less than that in the wrist-dominant group. When patients were subdivided by duration of disease, the Larsen grade of the feet was significantly higher than that of the wrist in the first quadrant subgroup, but this was reversed with increasing duration of disease. Anti-CCP status was a significant predictive factor for joint destruction in the wrist but not in the feet, while RF status was not predictive in either the wrist or the feet. Conclusions Joint destruction in the feet started earlier than in the wrist, but the latter progresses faster with increasing duration of disease. Anti-CCP status predicts joint destruction in the wrist better than in the feet.
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Affiliation(s)
- Yosuke Hamamoto
- Department of Orthopedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiromu Ito
- Department of Orthopedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
- * E-mail:
| | - Moritoshi Furu
- Department of Orthopedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of the Control for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Motomu Hashimoto
- Department of the Control for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takao Fujii
- Department of the Control for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masahiro Ishikawa
- Department of Orthopedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of the Control for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Noriyuki Yamakawa
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Chikashi Terao
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masayuki Azukizawa
- Department of Orthopedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takahiro Iwata
- Department of Orthopedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tsuneyo Mimori
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shuichi Matsuda
- Department of Orthopedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Audo R, Daien C, Papon L, Lukas C, Vittecoq O, Hahne M, Combe B, Morel J. Osteoprotegerin and tumor necrosis factor-related apoptosis-inducing ligand as prognostic factors in rheumatoid arthritis: results from the ESPOIR cohort. Arthritis Res Ther 2015. [PMID: 26220665 PMCID: PMC4518710 DOI: 10.1186/s13075-015-0705-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction We previously reported that low ratio of osteoprotegerin (OPG) to tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) was associated with Disease Activity Score in 28 joints (DAS28) remission at 6 months in patients with early rheumatoid arthritis (RA). Here, we aimed to evaluate the value of baseline OPG/TRAIL ratio in predicting clinical and radiological outcomes in patients with early RA in the ESPOIR cohort. Methods OPG and TRAIL serum concentrations were assessed in the ESPOIR cohort patients. Patients with definite RA were included in this study. Patients were excluded if they had high erosion score at baseline (>90th percentile) or received biological therapy during the first 2 years of follow-up. Data were analyzed by univariate analysis and multivariate logistic regression to predict 1-year DAS28 remission and 2-year radiographic disease progression. Results On univariate analysis of 399 patients, OPG/TRAIL ratio at baseline was significantly lower in patients with than without remission at 1 year (p = 0.015). On multivariate logistic regression including age, gender, body mass index and DAS28, low OPG/TRAIL ratio was independently associated with remission at 1 year (odds ratio 1.68 [95 % confidence interval 1.01–2.79]). On univariate analysis, high OPG/TRAIL ratio at baseline was associated with rapid progression of erosion at 2 years (p = 0.041), and on multivariate logistic regression including age, anti-citrullinated protein antibody positivity and C-reactive protein level, OPG/TRAIL ratio independently predicted rapid progression of erosion at 2 years. Conclusions OPG/TRAIL ratio at baseline was an independent predictor of 1-year remission and 2-year rapid progression of erosion for patients with early rheumatoid arthritis. Thus, OPG/TRAIL ratio could be included in matrix prediction scores to predict rapid radiographic progression. Further confirmation in an independent cohort is warranted.
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Affiliation(s)
- Rachel Audo
- Department of Rheumatology, Lapeyronie Hospital, Montpellier University, 371 avenue doyen Giraud, 34295, Montpellier, France. .,Montpellier University, 163 rue Auguste Broussonnet, 34000, Montpellier, France. .,Institut de Génétique Moléculaire de Montpellier, CNRS-UMR 5535, 1919 Route de Mende, 34293, Montpellier, France.
| | - Claire Daien
- Department of Rheumatology, Lapeyronie Hospital, Montpellier University, 371 avenue doyen Giraud, 34295, Montpellier, France. .,Montpellier University, 163 rue Auguste Broussonnet, 34000, Montpellier, France. .,Institut de Génétique Moléculaire de Montpellier, CNRS-UMR 5535, 1919 Route de Mende, 34293, Montpellier, France.
| | - Laura Papon
- Montpellier University, 163 rue Auguste Broussonnet, 34000, Montpellier, France. .,Institut de Génétique Moléculaire de Montpellier, CNRS-UMR 5535, 1919 Route de Mende, 34293, Montpellier, France.
| | - Cédric Lukas
- Department of Rheumatology, Lapeyronie Hospital, Montpellier University, 371 avenue doyen Giraud, 34295, Montpellier, France. .,Montpellier University, 163 rue Auguste Broussonnet, 34000, Montpellier, France.
| | - Olivier Vittecoq
- Department of Rheumatology and CIC/CRB 1404, Rouen University Hospital, Inserm U 905, Institute for Research and Innovation in Biomedicine, 1, rue de Germont, 76031 Rouen, France.
| | - Michael Hahne
- Montpellier University, 163 rue Auguste Broussonnet, 34000, Montpellier, France. .,Institut de Génétique Moléculaire de Montpellier, CNRS-UMR 5535, 1919 Route de Mende, 34293, Montpellier, France. .,Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Bernard Combe
- Department of Rheumatology, Lapeyronie Hospital, Montpellier University, 371 avenue doyen Giraud, 34295, Montpellier, France. .,Montpellier University, 163 rue Auguste Broussonnet, 34000, Montpellier, France. .,Institut de Génétique Moléculaire de Montpellier, CNRS-UMR 5535, 1919 Route de Mende, 34293, Montpellier, France.
| | - Jacques Morel
- Department of Rheumatology, Lapeyronie Hospital, Montpellier University, 371 avenue doyen Giraud, 34295, Montpellier, France. .,Montpellier University, 163 rue Auguste Broussonnet, 34000, Montpellier, France. .,Institut de Génétique Moléculaire de Montpellier, CNRS-UMR 5535, 1919 Route de Mende, 34293, Montpellier, France.
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Guellec D, Milin M, Cornec D, Tobon GJ, Marhadour T, Jousse-Joulin S, Chiocchia G, Vittecocq O, Devauchelle-Pensec V, Saraux A. Eosinophilia predicts poor clinical outcomes in recent-onset arthritis: results from the ESPOIR cohort. RMD Open 2015; 1:e000070. [PMID: 26509068 PMCID: PMC4613150 DOI: 10.1136/rmdopen-2015-000070] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 03/07/2015] [Accepted: 03/22/2015] [Indexed: 12/15/2022] Open
Abstract
Objectives To determine the prevalence of eosinophilia in patients with recent-onset arthritis suggestive of rheumatoid arthritis (RA) and to describe their features and outcomes. Methods We performed an ancillary study of data from a French prospective multicentre cohort study monitoring clinical, laboratory and radiographic data in patients with inflammatory arthritis of 6 weeks to 6 months duration. We determined the proportion of patients with eosinophilia, defined as a count >500/mm3, at baseline and after 3 years. Features of patients with and without baseline eosinophilia were compared. Results Baseline eosinophilia was evidenced in 26 of 804 (3.2%) patients; their mean eosinophil count was 637.7±107/mm3. Baseline eosinophilia was ascribed to atopic syndrome in 6 of 26 (23.1%) patients. After 3 years, patients with eosinophilia had higher Health Assessment Questionnaire scores (0.9 vs 0.5, p=0.004), higher patient visual analogue scale activity score and morning stiffness intensity (p=0.05), and were more often taking disease-modifying antirheumatic drugs (p=0.02). Baseline eosinophilia was not associated with presence of extra-articular manifestations. Conclusions Eosinophilia is rare in recent-onset arthritis suggestive of RA, and is usually directly related to the rheumatic disease. Our data suggest that patients with mild eosinophilia at diagnosis could respond worse to the treatment than those without.
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Affiliation(s)
- Dewi Guellec
- Department of Rheumatology , CHU de la Cavale Blanche, Boulevard Tanguy Prigent , Brest , France
| | - Morgane Milin
- Department of Rheumatology , CHU de la Cavale Blanche, Boulevard Tanguy Prigent , Brest , France
| | - Divi Cornec
- Department of Rheumatology , CHU de la Cavale Blanche, Boulevard Tanguy Prigent , Brest , France ; EA 2216, INSERM ESPRI, ERI29 Université Bretagne Occidentale , Brest , France
| | - Gabriel J Tobon
- Department of Internal Medicine, Division of Rheumatology , Fundación Valle del Lili, ICESI University School of Medicine , Cali , Columbia
| | - Thierry Marhadour
- Department of Rheumatology , CHU de la Cavale Blanche, Boulevard Tanguy Prigent , Brest , France
| | - Sandrine Jousse-Joulin
- Department of Rheumatology , CHU de la Cavale Blanche, Boulevard Tanguy Prigent , Brest , France ; EA 2216, INSERM ESPRI, ERI29 Université Bretagne Occidentale , Brest , France
| | - Gilles Chiocchia
- Simone Veil Department of Health Sciences , Inserm U1173, University Versailles-Saint-Quentin , Montigny-Le-Bretonneux, Ile de France , France
| | - Olivier Vittecocq
- Rhumatologie & Inserm, U905 (IRIB) CIC 1404, CHU Hôpitaux de Rouen , Rouen , France
| | - Valérie Devauchelle-Pensec
- Department of Rheumatology , CHU de la Cavale Blanche, Boulevard Tanguy Prigent , Brest , France ; EA 2216, INSERM ESPRI, ERI29 Université Bretagne Occidentale , Brest , France
| | - Alain Saraux
- Department of Rheumatology , CHU de la Cavale Blanche, Boulevard Tanguy Prigent , Brest , France ; EA 2216, INSERM ESPRI, ERI29 Université Bretagne Occidentale , Brest , France
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Association of Anti-Porphyromonas gingivalisAntibody Titers With Nonsmoking Status in Early Rheumatoid Arthritis: Results From the Prospective French Cohort of Patients With Early Rheumatoid Arthritis. Arthritis Rheumatol 2015; 67:1729-37. [DOI: 10.1002/art.39118] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 01/10/2015] [Accepted: 03/12/2015] [Indexed: 01/10/2023]
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23
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Miceli-Richard C, Taylor KE, Nititham J, Seror R, Nocturne G, Boudaoud S, Dieude P, Constantin A, Devauchelle-Pensec V, Tobón GJ, Mariette X, Criswell LA. Genetic contribution of DKK-1 polymorphisms to RA structural severity and DKK-1 level of expression. Ann Rheum Dis 2015; 74:1480-1. [PMID: 25805736 DOI: 10.1136/annrheumdis-2014-206530] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 03/08/2015] [Indexed: 11/04/2022]
Affiliation(s)
- Corinne Miceli-Richard
- Service de Rhumatologie, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, France Unité INSERM U1012-Université Paris Sud, Le Kremlin Bicêtre, France
| | - Kimberly E Taylor
- Division of rheumatology, Rosalind Russell / Ephraim P Engleman Rheumatology Research Center, University of California, San Francisco, California, USA
| | - Joanne Nititham
- Division of rheumatology, Rosalind Russell / Ephraim P Engleman Rheumatology Research Center, University of California, San Francisco, California, USA
| | - Raphaèle Seror
- Service de Rhumatologie, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, France
| | - Gaetane Nocturne
- Unité INSERM U1012-Université Paris Sud, Le Kremlin Bicêtre, France
| | - Saida Boudaoud
- Unité INSERM U1012-Université Paris Sud, Le Kremlin Bicêtre, France
| | - Philippe Dieude
- Service de rhumatologie, Assistance-Publique- Hôpitaux de Paris, Hôpital Bichat Claude-Bernard, Paris, France
| | - Arnaud Constantin
- INSERM, Toulouse III University and Department of Rheumatology, Purpan Hospital, CHU, Toulouse, France
| | | | | | - Xavier Mariette
- Service de Rhumatologie, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, France Unité INSERM U1012-Université Paris Sud, Le Kremlin Bicêtre, France
| | - Lindsey A Criswell
- Division of rheumatology, Rosalind Russell / Ephraim P Engleman Rheumatology Research Center, University of California, San Francisco, California, USA
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Combe B, Rincheval N. Early lessons from the recent-onset rheumatoid arthritis cohort ESPOIR. Joint Bone Spine 2014; 82:13-7. [PMID: 25238951 DOI: 10.1016/j.jbspin.2014.07.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2014] [Indexed: 12/18/2022]
Abstract
ESPOIR is a French multicenter cohort of patients with undifferentiated arthritis enrolled within six months of symptom onset, naive to disease-modifying antirheumatic drugs and corticosteroid therapy, and either having rheumatoid arthritis (RA) or being at risk for progression to RA. The cohort is sponsored by the French Society for Rheumatology (Société française de rhumatologie [SFR]). Between December 2002 and March 2005, 813 patients were enrolled at 14 regional university hospitals, with the participation of a network of community-based rheumatologists. The objective was to establish a database on recent-onset inflammatory joint disease and, more specifically, on RA to serve for scientific research in the clinical, epidemiological, pathophysiological, and healthcare-cost fields. Ten years after enrolment were started, the cohort still has about 500 patients. The scientific committee has approved 104 clinical research projects, of which many are ongoing, and 54 original articles written by numerous French and international groups have been published. These projects cover a vast spectrum of topics including environmental factors, diagnosis, outcomes, prognosis, disease evaluation, imaging, genetics, biomarkers, costs, and RA management strategies.
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Affiliation(s)
- Bernard Combe
- Département rhumatologie, université Montpellier I, hôpital Lapeyronie, 34295 Montpellier cedex 5, France.
| | - Nathalie Rincheval
- Département rhumatologie, université Montpellier I, hôpital Lapeyronie, 34295 Montpellier cedex 5, France
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Juge PA, van Steenbergen HW, Constantin A, Tobon GJ, Schaeverbeke T, Gazal S, Combe B, Devauchelle-Pensec V, Nigon D, van der Helm-van Mil AHM, Dieude P. SPP1 rs9138 variant contributes to the severity of radiological damage in anti-citrullinated protein autoantibody-negative rheumatoid arthritis. Ann Rheum Dis 2014; 73:1840-3. [PMID: 24936586 DOI: 10.1136/annrheumdis-2014-205539] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE We recently reported an association of the SPP1 rs9138 and rs11439060 functional variants with the risk of rheumatoid arthritis (RA), the association being greater in anti-citrullinated protein autoantibody (ACPA)-negative patients. We hypothesised that SPP1 may contribute to the severity of joint destruction in RA, specifically in the ACPA-negative population. METHODS Patients with RA in the ESPOIR cohort underwent genotyping for SPP1 rs9138 and rs11439060. Radiographs of the hands and feet were obtained at the first visit and at 1- and 2-year follow-up. Association analyses were performed by ACPA status. A replication study of the relevant subset of the Leiden Early Arthritis Clinic (EAC) cohort was performed. RESULTS In the ESPOIR cohort (652 patients), rs9138 was significantly associated with radiological progression of joint destruction at 2 years, the association being restricted to 358 ACPA-negative patients (p=0.034). In the replication study with the Leiden EAC cohort (273 ACPA-negative patients), rs4754, which is in complete linkage disequilibrium with rs9138, was significantly associated with joint damage progression in ACPA-negative patients at 2- and 7-year follow-up (p=0.019 and p=0.005, respectively). Combined analysis of the two cohorts revealed a 0.95-fold rate of joint destruction per year per minor allele (p=0.022). CONCLUSIONS The SPP1 rs9138 variant contributes to joint damage progression in ACPA-negative RA.
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Affiliation(s)
- Pierre-Antoine Juge
- Department of Rheumatology, DHU FIRE, Assistance Publique Hôpitaux de Paris, Bichat Hospital, Université Paris Diderot, PRES Sorbonne Paris Cité, Paris, France
| | | | - Arnaud Constantin
- UMR 1027, INSERM, Toulouse III University and Department of Rheumatology, Purpan Hospital, CHU Toulouse, Toulouse, France
| | - Gabriel J Tobon
- Department of Rheumatology, Morvan Hospital, Cavale Blanche Hospital, Brittany University, Brest, France
| | - Thierry Schaeverbeke
- Department of Rheumatology, Pellegrin Hospital, Bordeaux Selagen University, Bordeaux, France
| | - Steven Gazal
- Plateforme de Génomique Constitutionnelle Assistance Publique Hôpitaux de Paris, Bichat Hospital, Université Paris Diderot, PRES Sorbonne Paris Cité, Paris, France
| | - Bernard Combe
- Department of Rheumatology, Montpellier University Hospital, Montpellier, France
| | - Valérie Devauchelle-Pensec
- Department of Rheumatology, Morvan Hospital, Cavale Blanche Hospital, Brittany University, Brest, France
| | - Delphine Nigon
- UMR 1027, INSERM, Toulouse III University and Department of Rheumatology, Purpan Hospital, CHU Toulouse, Toulouse, France
| | | | - Philippe Dieude
- Department of Rheumatology, DHU FIRE, Assistance Publique Hôpitaux de Paris, Bichat Hospital, Université Paris Diderot, PRES Sorbonne Paris Cité, Paris, France INSERM U699, Bichat Faculty of Medicine, Université Paris Diderot, PRES Sorbonne Paris Cité, Paris, France
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Ruyssen-Witrand A, Guernec G, Nigon D, Tobon G, Jamard B, Rat AC, Vittecoq O, Cantagrel A, Constantin A. Aiming for SDAI remission versus low disease activity at 1 year after inclusion in ESPOIR cohort is associated with better 3-year structural outcomes. Ann Rheum Dis 2014; 74:1676-83. [DOI: 10.1136/annrheumdis-2013-204906] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 04/06/2014] [Indexed: 11/03/2022]
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