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Clinical joint inactivity predicts structural stability in patients with established rheumatoid arthritis
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,...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4838760/ https://www.ncbi.nlm.nih.gov/pubmed/27110386 http://dx.doi.org/10.1136/rmdopen-2016-000241 |
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author | Gärtner, M Sigmund, I K Alasti, F Supp, G Radner, H Machold, K Smolen, J S Aletaha, D |
author_facet | Gärtner, M Sigmund, I K Alasti, F Supp, G Radner, H Machold, K Smolen, J S Aletaha, D |
author_sort | Gärtner, M |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-4838760 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-48387602016-04-22 Clinical joint inactivity predicts structural stability in patients with established rheumatoid arthritis Gärtner, M Sigmund, I K Alasti, F Supp, G Radner, H Machold, K Smolen, J S Aletaha, D RMD Open Rheumatoid Arthritis 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. BMJ Publishing Group 2016-04-07 /pmc/articles/PMC4838760/ /pubmed/27110386 http://dx.doi.org/10.1136/rmdopen-2016-000241 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Rheumatoid Arthritis Gärtner, M Sigmund, I K Alasti, F Supp, G Radner, H Machold, K Smolen, J S Aletaha, D Clinical joint inactivity predicts structural stability in patients with established rheumatoid arthritis |
title | Clinical joint inactivity predicts structural stability in patients with established rheumatoid arthritis |
title_full | Clinical joint inactivity predicts structural stability in patients with established rheumatoid arthritis |
title_fullStr | Clinical joint inactivity predicts structural stability in patients with established rheumatoid arthritis |
title_full_unstemmed | Clinical joint inactivity predicts structural stability in patients with established rheumatoid arthritis |
title_short | Clinical joint inactivity predicts structural stability in patients with established rheumatoid arthritis |
title_sort | clinical joint inactivity predicts structural stability in patients with established rheumatoid arthritis |
topic | Rheumatoid Arthritis |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4838760/ https://www.ncbi.nlm.nih.gov/pubmed/27110386 http://dx.doi.org/10.1136/rmdopen-2016-000241 |
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