Source: Ann Rheum Dis  |  Posted 9 years ago

The vast majority of people with early rheumatoid arthritis (RA) are still coping well on their own after a decade with the condition.

This is one finding of a 10-year prospective study of the health status, disease process and damage in early RA patients by researchers from the Department of Rheumatology, Lund University Hospital, Lund, Sweden.

After 10 years, 94 percent of 158 study patients were managing their daily life activities independently (functional class I-II), report Dr E Lindqvist and colleagues.

Overall, 168 of 183 patients with RA duration of less than two years at study outset completed the entire follow-up period. They were assessed annually at a team care unit.

Of all 183 patients, 137 (75 percent) had received disease modifying antirheumatic drugs, and 84 (46 percent) had been treated with low dose oral glucocorticoids.

After 10 years, as measured by the Health Assessment Questionnaire (HAQ), 20 percent had almost no disability, 28 percent were mildly disabled and 10 percent were seriously disabled. Median score had increased from 0.8 to 1.1.

Disease activity was significantly reduced. Seventy-nine percent of patients (133) had a relapsing remitting disease course, and 18 percent (30 patients) were in remission (per American College of Rheumatology criteria).

Thirty patients (17 percent) had undergone large joint replacements, and 15 (eight percent) had developed major extra-articular complications.

The HAQ score during the first three months predicted disability at 10 years with an odds ratio of 13.4.

This kind of prospective study provides important knowledge of the variable long term prognosis of RA as well as necessary background information for clinical trials of new treatment modalities, these researchers suggest.