Main Article Content

Abstract

Objective: This study was implemented to determine the joint damage predictor in rheumatoid arthritis (RA).

Methods: A cross-sectional study was conducted on outpatients of the rheumatology clinic at Cipto Mangunkusumo General Hospital who had suffered from RA for more than 2 years during the period from October 1, 1999 to June 30, 2000. During this period, we obtained 23 RA patients who fulfi lled the inclusion and exclusion criteria. We evaluated the patients’ medical data that included gender, education, age of onset, rheumatoid factor (RF), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Then we carried
out examinations and tests including X-ray of hand and wrist joints, RF, CRP, and ESR. The degree of joint damage was evaluated using the Larsen score.

Results: Twenty three patients—all women, mean age of onset was 36.7 years, mean duration of disease was 62.8 months, educational level with high school degree or above were found in 19 cases (82.6%), and RF (+) at initial treatment were found in 10 cases (43.5%). The mean ESR at initial treatment was 77.9 mm/hr and CRP at initial treatment was between 0 and 768 mg/dL. The Larsen score ranged between 0 and 68 with a mean
of 21.7. In bivariate analysis, the Larsen score was signifi cantly higher in the group with positive RF at initial treatment compared to that in the group with negative RF at initial treatment (p = 0.031). C-reactive protein and ESR at initial treatment and the age of onset did not have any signifi cant correlation with the Larsen score, but there was a signifi cant correlation of CRP and ESR during the study with the the Larsen score.

Conclusion: RF level was the most signifi cant predictor in determining the degree of joint damage according to the Larsen score while initial positive RF had lower signifi cance level.

Article Details

How to Cite
Sumariyono, S., & Isbagio, H. (2018). Predictor of joint damage in rheumatoid arthritis. Indonesian Journal of Rheumatology, 2(1). https://doi.org/10.37275/ijr.v2i2.31

References

  1. Goronzy J, Weyand CM. Rheumatoid arthritis: epidemiology, pathology, and pathogenesis. In: Klippel JH, editor. Primer on the rheumatic disease. 11th ed. Atlanta: Arthritis Foundation; 1997. p. 155–60.
  2. Combe B, Eliaou JF, Daures JP, Meyer O, Clot J, Sany J. Prognostic factor in rheumatoid arthritis: comparative study of two subset of patients according to severity of articular damage. Br J rheumatol 1995;34:529–34.
  3. Gordon DA, Hasting DE. Rheumatoid arthritis, clinical feature: early, progressive, and late disease. In: Klippel JH, Dieppe PH, editors. Rheumatology. Baltimore: Mosby; 1994. p. 3.4.1–14.
  4. American College of Rheumatogy, ad hoc committee on clinical guidelines. Guidelines for the management of rheumatoid arthritis. Arthritis Rheum 1996;39:713–22.
  5. Fuch HA, Sergent JS. Rheumatoid arthritis: the clinical feature. In: Koopman WJ, editor. Arthritis and allied condition: a textbook of rheumatology. 13th ed. Baltimore: Williams & Wilkins; 1997. p. 1041–65.
  6. Plant MJ, Jones PW, Saklatvala J, Ollier WER, Dawes PT. Pattern of radiological progression in early rheumatoid arthritis: results of an 8-year prospective study. J Rheumatol 1998;25:417–26.
  7. Kim JM, Weisman MH. When does rheumatoid arthritis begin and why do we need to know? (review). Arthritis Rheum 2000;43:473–84.
  8. Anderson RJ. Rheumatoid arthritis, clinical and laboratory fi nding. In: Klippel JH, editor. Primer on the rheumatic disease. 11th ed. Atlanta: Arthritis Foundation; 1997. p. 161–7.
  9. Mottonen T, Paimela L, Leirisalo-repo M, Kautimen H, Ilonen J, Honnonen P. Only high disease activity and positive rheumatoid factor indicate poor prognosis in patients with early RA treated with “sawtooth†strategy. Ann Rheum Dis 1998;57:533–9.
  10. Riel V, Gestel V, De Putte V. Development and validation of response criteria in rheumatoid arthritis: steps towards on international consensus on prognostic factor. Br J Rheumatol 1996;35(suppl 2):4–7.
  11. Brower AC. Rheumatoid arthritis: Imaging. In: Klippel JH, Dieppe PH, editors. Rheumatology. Baltimore: Mosby; 1994. p. 3.6.1–8.
  12. Paimela L, Polosua, Leirisalo-Repo, Helve Aito. Prognostic value of quantitative measurement of rheumatoid factor in early rheumatoid arthritis. Br J Rheumatol 1995;34:1146–50.
  13. Morone I, Valenzuela A, Garcia A, Yelanis J. Sanches B. Association of the shared epitope with radiological severity of rheumatoid arthritis. J Rheumatol 1996;23:6–9.
  14. Leuwen MA, Rijswijk MH, Shuter WJ, Riel PLCM, Kuper IH, van de Putte LBA, et al. Individual relationship between progression of radiological damage and acute phase response in early rheumatoid arthritis. Toward development of a decision support system. J Rheumatol 1997;24:20–7.
  15. Kaarela K, Kautiainen H. Contineus progression of radiological destruction
  16. in seropositive rheumatoid arthritis. J Rheumatol 1997;24:1285–7.
  17. Wagner U, Kaltenhauser S, Sauer H, Arnold S, Seidel W, Hantzschel H, et al. HLA marker and prediction of course and outcome in rheumatoid arthritis. Arthritis Rheum 1997;40:341–51.
  18. Harris ED. Clinical feature of rheumatoid arthritis. In: Kelley WN, Ruddy
  19. S, Horris ED, Sledge CB, editors. Textbook of rheumatology. 5th ed. Philadelphia: WB Saunder Company; 1997. p. 898–926.
  20. Listing J, Rau R, Muller B, Alten R, Czerwony G, Gromnica-Ihle, et al. HLA-DRB1 genes, rheumatoid factor, and elevated CRP: independent risk factor of radiographic progression in early rheumatoid arthritis. J Rheumatol 2000;27:2100–9.
  21. Schellekens GA, Visser H, Jong BA, Hoogen FHJ, Hazes JM, Bredveld FC, et al. The diagnostic properties of rheumatoid arthritis antibodiesrecognizing a cyclic citrullinated peptide. Arthritis Rheum 2000;43:155–63.
  22. Yamanaka H, Matsuda Y, Tanaka M, Sendo W, Nakajima H, Kamatani N. Serum matrix metalloproteinase-3 as a predictor of the degree of joint destruction during the six months after measurement, in patient with early rheumatoid arthritis. Arthritis Rheum 2000;43:852–8.
  23. Larsen A, Dale K, Eek M. Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference fi lm. Acta radiol1977;18:481–91.
  24. Peltoma R, Leirisalo-Repo M, Helve T, Paimela L. Effect of age on 3 year outcome in early rheumatoid arthritis. J Rheumatol 2000;27(3):638–43.
  25. Heijde VD. Joint erosions and patient with early rheumatoid arthritis. Br J Rheumatol 1995;34(suppl 2):74–8.
  26. Matsuda Y. Time lag between active joint infl amation and radiological progression in patient with early rheumatoid arthritis. J Rheumatol 1998;25:427–32.
  27. Zeben V. Clinical signifi cance of rheumatoid factor in early rheumatoid arthritis. Ann Rheum Dis 1992;51:1029–35.
  28. Hazes JM. What we have learned about risk factor for persintence and severity from early arthritis clinics. Proceedings of the Symposium in Early Rheumatoid Arthritis; 2000 Oct; Philadelphia.