Rheumatology 2000; 39: 732-741
© 2000 British Society for Rheumatology
The course of rheumatoid arthritis and predictors of psychological, physical and radiographic outcome after 5 years of follow-up
Department of Rheumatology, Diakonhjemmet Hospital, Box 23 Vinderen, N-0319 Oslo,
1 Department of Behavioural Sciences in Medicine, University of Oslo, Box 1111 Blindern, N-0317 Oslo, Norway and
2 School of Public Health, University of Nancy, Box 184, F-54505 Nancy, France
Objective. To examine the course of RA over 5 yr and identify predictors of psychological, physical and radiographic outcome.
Patients and methods. Out of 238 patients with rheumatoid arthritis of no more than 4 (mean 2.2) yr duration, 182 (76%) completed a clinical examination with follow-up at 1, 2, and 5 yr. The course of the disease was assessed by measures of psychological and physical health status, disease process and radiographic damage.
Results. Over 5 yr we observed at a group level a stable disease course for measures of disease process, psychological and physical health status. Radiographic damage progressed. Health status and radiographic damage after 5 yr were predicted by the baseline measures for the respective outcome. Physical function was also predicted by age and by psychological status when the physical dimension of the Arthritis Impact Measurement Scales was chosen as outcome variable. Erythrocyte sedimentation rate and presence of rheumatoid factor predicted radiographic progression.
Conclusions. The 5 yr course of RA was characterized by preserved health status measures and clinically preserved disease process measures, whereas joint damage progressed steadily. Outcomes after 5 yr can be predicted partly by certain measures at baseline.
KEY WORDS: Rheumatoid arthritis, Prospective study, HAQ, AIMS, Radiographic damage, Prognostic factors, Prognosis, Psychological distress, Physical disability, Health status measures.
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