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Open Access 01-12-2021 | Infliximab | Research article

Assessing the risk of rapid radiographic progression in Hungarian rheumatoid arthritis patients

Authors: Edit Végh, János Gaál, Pál Géher, Edina Gömöri, Attila Kovács, László Kovács, Katalin Nagy, Edit Feketéné Posta, László Tamási, Edit Tóth, Eszter Varga, Andrea Domján, Zoltán Szekanecz, Gabriella Szűcs

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

Abstract

Background

The outcome of rheumatoid arthritis (RA) should be determined early. Rapid radiological progression (RRP) is > or = 5 units increase according to the van der Heijde-Sharp score within a year. The risk of RRP can be estimated by a matrix model using non-radiographic indicators, such as C-reactive protein (CRP), rheumatoid factor (RF) and swollen joint count (SJC).

Patients and methods

A non-interventional, cross-sectional, retrospective study was conducted in eleven Hungarian arthritis centres. We assessed RRP risk in biologic-naïve RA patients with the prevalence of high RRP risk as primary endpoint. RRP was calculated according to this matrix model. As a secondary endpoint, we compared RRP in methotrexate (MTX) responders vs non-responders.

Results

We analyzed data from 1356 patients. Mean CRP was 17.7 mg/l, RF was 139.3 IU/ml, mean 28-joint disease activity score (DAS28) was 5.00 and mean SJC was 6.56. Altogether 18.2% of patients had high risk (≥40%) of RRP. RA patients with high RRP risk of RRP (n = 247) had significantly lower age compared to those with RRP < 40% (n = 1109). MTX non-response (OR: 16.84), male gender (OR: 1.67), erosions at baseline (OR: 1.50) and ACPA seropositivity (OR: 2.18) were independent predictors of high-risk RRP. Male gender (OR: 5.20), ACPA seropositivity (OR: 4.67) and erosions (OR: 7.98) were independent predictors of high RRP risk in MTX responders.

Conclusions

In this Hungarian study, high RRP risk occurred in 18% of RA patients. These patients differ from others in various parameters. RRP was associated with non-response to MTX.

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Title: Assessing the risk of rapid radiographic progression in Hungarian rheumatoid arthritis patients
Authors: Edit Végh
János Gaál
Pál Géher
Edina Gömöri
Attila Kovács
László Kovács
Katalin Nagy
Edit Feketéné Posta
László Tamási
Edit Tóth
Eszter Varga
Andrea Domján
Zoltán Szekanecz
Gabriella Szűcs
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Infliximab
Methotrexate
Methotrexate
Rheumatoid Arthritis
Published in: BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-021-04192-x

At a glance: The STEP trials

Springer Medicine

Assessing the risk of rapid radiographic progression in Hungarian rheumatoid arthritis patients

Abstract

Background

Patients and methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Patients and methods

Results

Conclusions

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