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Outcome in rheumatoid arthritis. A 1985 inception cohort study
M E Suarez-Almazor1, C L Soskolne, L D Saunders
1Department of Medicine, Faculty of Medicine, University of Alberta, Edmonton, Canada.
The Journal of Rheumatology
|August 1, 1994
Summary
This study followed rheumatoid arthritis (RA) patients from 1985, finding their long-term prognosis is better than previously thought. Early treatment with second-line therapy may improve outcomes for rheumatoid arthritis patients.
Area of Science:
- Rheumatology
- Clinical Epidemiology
Background:
- Rheumatoid arthritis (RA) prognosis has historically been considered poor.
- Previous studies may have selection bias due to focusing on prevalent cases in tertiary centers.
Purpose of the Study:
- To describe the clinical status and long-term outcome of a 1985 inception cohort of rheumatoid arthritis (RA) patients.
- To evaluate prognostic factors and the impact of early treatment.
Main Methods:
- Retrospective establishment of a 1985 inception cohort of RA patients in Edmonton.
- Assessment using joint counts, radiological scores, and the modified Health Assessment Questionnaire (MHAQ) between 1991-1992.
Main Results:
- 128 RA patients (70% female, mean onset age 52) were included.
- At 6-7 years post-onset, 32% had no joint swelling, 23% had no radiographic erosions, and 31% had normal MHAQ function.
- Rheumatoid factors and nodules correlated with worse outcomes; sex, age, and mode of onset did not.
Conclusions:
- The long-term prognosis of RA may be less severe than previously reported.
- Early treatment with second-line therapy might contribute to better outcomes.
- Findings suggest potential selection bias in prior studies of prevalent RA cases.