Predictors of outcome at two years in patients with rheumatoid arthritis

The prognostic value of clinical and laboratory measures in 72 patients with rheumatoid arthritis (RA), seen initially within 18 months of disease onset, in predicting function outcome after a further two years was assessed. Limitation of wrist extension was associated with a slow disease onset, a high articular index and a high latex titre. A reduction in global functional capacity, as measured by the Stanford Health Assessment Questionnaire, was associated with a high initial articular index and a high latex titre. Neither outcome was associated with the initial level of acute phase reactants nor with patient or physician's initial assessment of disease activity. It is concluded, first, that factors predicting early disability outcome in RA are not identical to those associated with continuing disease activity; and secondly, that patients' and physicians' judgment of disease activity at diagnosis do not carry any prognostic value for functional outcome two years later.