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Arthritis Research & Therapy
Published in: Arthritis Research & Therapy 4/2006

01-08-2006 | Review

Aspects of early arthritis. What determines the evolution of early undifferentiated arthritis and rheumatoid arthritis? An update from the Norfolk Arthritis Register

Authors: Deborah PM Symmons, Alan J Silman

Published in: Arthritis Research & Therapy | Issue 4/2006

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Abstract

Over 3500 patients with recent onset inflammatory polyarthritis (IP) have been recruited by the Norfolk Arthritis Register (NOAR) since 1990. Longitudinal data from this cohort have been used to examine the prevalence and predictors of remission, functional disability, radiological outcome, cardiovascular mortality and co-morbidity and the development of non-Hodgkin's lymphoma. Rheumatoid factor titre, high baseline C-reactive protein and high baseline HAQ score are all predictors of a poor outcome. There is a strong association between possession of the shared epitope and the development of erosions. Patients who satisfy the American College of Rheumatology criteria for rheumatoid arthritis (RA) have a worse prognosis than those who do not. However, it appears that these patients are a poorly defined subset of all those with IP rather than having an entirely separate disease entity. New statistical techniques offer exciting possibilities for using longitudinal datasets such as NOAR to explore the long-term effects of treatment in IP and RA.
Literature
1.
Bunn DK, Shepstone L, Galpin LM, Wiles NJ, Symmons DP: The NOAR Damaged Joint Count (NOAR-DJC): a clinical measure for assessing articular damage in patients with early inflammatory polyarthritis including rheumatoid arthritis. Rheumatology (Oxford). 2004, 43: 1519-1525. 10.1093/rheumatology/keh372.CrossRef
2.
Fries JF, Spitz P, Kraines RG, Holman HR: Measurement of patient outcome in arthritis. Arthritis Rheum. 1980, 23: 137-145.CrossRefPubMed
3.
Kirwan JR, Reeback JS: Stanford Health Assessment questionnaire modified to assess disability in British patients with rheumatoid arthritis. Br J Rheumatol. 1986, 25: 206-209.CrossRefPubMed
4.
Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS, et al: The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988, 31: 315-324.CrossRefPubMed
5.
Wiles N, Symmons DPM, Harrison B, Barrett E, Barrett JH, Scott DGI, Silman AJ: Estimating the incidence of rheumatoid arthritis: trying to hit a moving target?. Arthritis Rheum. 1999, 42: 1339-1346. 10.1002/1529-0131(199907)42:7<1339::AID-ANR6>3.0.CO;2-Y.CrossRefPubMed
6.
Huizinga TW, Amos CI, van der Helm-van Mil AH, Chen W, van Gaalen FA, Jawaheer D, Schreuder GM, Wener M, Breedveld FC, Ahmad N, et al: Refining the complex rheumatoid arthritis phenotype based on specificity of the HLA-DRB1 shared epitope for antibodies to citrullinated proteins. Arthritis Rheum. 2005, 52: 3433-3438. 10.1002/art.21385.CrossRefPubMed
7.
Klareskog L, Stolt P, Lundberg K, Kallberg H, Bengtsson C, Grunewald J, Ronnelid J, Harris HE, Ulfgren AK, Rantapaa-Dahlqvist S, et al: A new model for an etiology of rheumatoid arthritis. Arthritis Rheum. 2006, 54: 38-46. 10.1002/art.21575.CrossRefPubMed
8.
Harrison B, Symmons D: Early inflammatory polyarthritis: results from the Norfolk Arthritis Register with a review of the literature. II. Outcome at three years. Rheumatology (Oxford). 2000, 39: 939-949. 10.1093/rheumatology/39.9.939.CrossRef
9.
Pinals RS, Masi AT, Larsen RA: Preliminary criteria for clinical remission in rheumatoid arthritis. Arthritis Rheum. 1981, 24: 1308-1315.CrossRefPubMed
10.
van der Heijde DM, van Riel PL, van Leeuwen MA, van't Hof MA, van Rijswijk MH, van de Putte LB: Older versus younger onset rheumatoid arthritis: results at onset and after 2 years of a prospective followup study of early rheumatoid arthritis. J Rheumatol. 1991, 18: 1285-1289.PubMed
11.
Prevoo ML, 't Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL: Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum. 1995, 38: 44-48.CrossRefPubMed
12.
van Gestel AM, Haagsma CJ, van Riel PL: Validation of rheumatoid arthritis improvement criteria that include simplified joint counts. Arthritis Rheum. 1998, 41: 1845-1850. 10.1002/1529-0131(199810)41:10<1845::AID-ART17>3.0.CO;2-K.CrossRefPubMed
13.
Green M, Marzo-Ortega H, Wakefield RJ, Astin P, Proudman S, Conaghan PG, Hordon L, Emery P: Predictors of outcome in patients with oligoarthritis: results of a protocol of intraarticular corticosteroids to all clinically active joints. Arthritis Rheum. 2001, 44: 1177-1783. 10.1002/1529-0131(200105)44:5<1177::AID-ANR201>3.0.CO;2-5.CrossRefPubMed
14.
Pincus T, Callahan LF: Formal education as a marker for increased mortality and morbidity in rheumatoid arthritis. J Chronic Dis. 1985, 38: 973-984. 10.1016/0021-9681(85)90095-5.CrossRefPubMed
15.
Wiles NJ, Dunn G, Barrett EM, Harrison BJ, Silman AJ, Symmons DP: One year followup variables predict disability 5 years after presentation with inflammatory polyarthritis with greater accuracy than at baseline. J Rheumatol. 2000, 27: 2360-2366.PubMed
16.
Wiles N, Dunn G, Barrett E, Silman A, Symmons D: Associations between demographic and disease-related variables and disability over the first five years of inflammatory polyarthritis: a longitudinal analysis using generalized estimating equations. J Clin Epidemiol. 2000, 53: 988-996. 10.1016/S0895-4356(00)00189-X.CrossRefPubMed
17.
Bukhari M, Lunt M, Scott DGI, Symmons D, Silman A: Increasing age at symptom onset is strongly associated with worse radiologic damage both at presentation and follow-up in an inception cohort of patients with inflammatory polyarthritis [abstract]. Arthritis Rheum. 2005, 52 (Suppl): S451-
18.
Bukhari M, Harrison B, Lunt M, Scott DG, Symmons DP, Silman AJ: Time to first occurrence of erosions in inflammatory polyarthritis: results from a prospective community-based study. Arthritis Rheum. 2001, 44: 1248-1253. 10.1002/1529-0131(200106)44:6<1248::AID-ART215>3.0.CO;2-8.CrossRefPubMed
19.
Bukhari M, Lunt M, Harrison BJ, Scott DG, Symmons DP, Silman AJ: Rheumatoid factor is the major predictor of increasing severity of radiographic erosions in rheumatoid arthritis: results from the Norfolk Arthritis Register Study, a large inception cohort. Arthritis Rheum. 2002, 46: 906-912. 10.1002/art.10167.CrossRefPubMed
20.
Forslind K, Ahlmen M, Eberhardt K, Hafstrom I, Svensson B: Prediction of radiological outcome in early rheumatoid arthritis in clinical practice: role of antibodies to citrullinated peptides (anti-CCP). Ann Rheum Dis. 2004, 63: 1090-1095. 10.1136/ard.2003.014233.PubMedCentralCrossRefPubMed
21.
Bukhari M, Thomson W, Scott DGI, Symmons DPM, Silman AJ: Antibodies to cyclic citrillinated peptide and rheumatoid factor in early undifferentiated inflammatory arthritis: results from the Norfolk Arthritis Register. Rheumatology. 2006, 45 (Suppl 1): i93-
22.
Goodson NJ, Wiles NJ, Lunt M, Barrett EM, Silman AJ, Symmons DP: Mortality in early inflammatory polyarthritis: cardiovascular mortality is increased in seropositive patients. Arthritis Rheum. 2002, 46: 2010-2019. 10.1002/art.10419.CrossRefPubMed
23.
Goodson N, Marks J, Lunt M, Symmons D: Cardiovascular admissions and mortality in an inception cohort of patients with rheumatoid arthritis with onset in the 1980s and 1990s. Ann Rheum Dis. 2005, 64: 1595-1601. 10.1136/ard.2004.034777.PubMedCentralCrossRefPubMed
24.
Marshall AT, Bunn DK, Symmons DPM, Harvey I, Shepstone L, Oakes S: Prevalence of self-reported angina in a community-based inception cohort of patients with inflammatory arthritis [abstract]. Arthritis Rheum. 2005, 52 (Suppl): S329-
25.
Franklin J, Lunt M, Bunn D, Symmons DPM, Silman A: Increased risk of lymphoma observed in a 10 year prospective study of a large primary-care based inception cohort of patients with inflammatory polyarthritis [abstract]. Arthritis Rheum. 2005, 52 (Suppl): S264-
26.
Wiles NJ, Lunt M, Barrett EM, Bukhari M, Silman AJ, Symmons DP, Dunn G: Reduced disability at five years with early treatment of inflammatory polyarthritis: results from a large observational cohort, using propensity models to adjust for disease severity. Arthritis Rheum. 2001, 44: 1033-1042. 10.1002/1529-0131(200105)44:5<1033::AID-ANR182>3.0.CO;2-G.CrossRefPubMed
27.
Bukhari MA, Wiles NJ, Lunt M, Harrison BJ, Scott DG, Symmons DP, Silman AJ: Influence of disease-modifying therapy on radiographic outcome in inflammatory polyarthritis at five years: results from a large observational inception study. Arthritis Rheum. 2003, 48: 46-53. 10.1002/art.10727.CrossRefPubMed
28.
Hider SL, Lunt M, Bunn D, Manning S, Symmons DPM, Silman AJ: Can we predict the outcome of methotrexate treatment in inflammatory polyarthritis using clinical variables?. Rheumatology. 2006, 45 (Suppl 1): I54-
29.
Harrison B, Thomson W, Symmons D, Ollier B, Wiles N, Payton T, Barrett E, Silman A: The influence of HLA-DRB1 alleles and rheumatoid factor on disease outcome in an inception cohort of patients with early inflammatory arthritis. Arthritis Rheum. 1999, 42: 2174-2183. 10.1002/1529-0131(199910)42:10<2174::AID-ANR19>3.0.CO;2-G.CrossRefPubMed
30.
Goodson NJ, Tellam DJ, Barton A, Lunt M, Barrett EM, Silman AJ, Symmons DPM: HLA DRB1 shared epitope bearing alleles associated with RA disease severity also predict mortality in patients with inflammatory polyarthritis. Rheumatology (Oxford). 2003, 42 (Suppl 1): 7-CrossRef
31.
Barton A, Platt H, Salway F, Symmons D, Barrett E, Bukhari M, Lunt M, Zeggini E, Eyre S, Hinks A, et al: Polymorphisms in the tumour necrosis factor gene are not associated with severity of inflammatory polyarthritis. Ann Rheum Dis. 2004, 63: 280-284. 10.1136/ard.2003.008680.PubMedCentralCrossRefPubMed
32.
Barton A, Platt H, Salway F, Symmons D, Lunt M, Worthington J, Silman A: Polymorphisms in the mannose binding lectin (MBL) gene are not associated with radiographic erosions in rheumatoid or inflammatory polyarthritis. J Rheumatol. 2004, 31: 442-447.PubMed
33.
Suzuki A, Yamada R, Chang X, Tokuhiro S, Sawada T, Suzuki M, Nagasaki M, Nakayama-Hamada M, Kawaida R, Ono M, et al: Functional haplotypes of PADI4, encoding citrullinating enzyme peptidylarginine deiminase 4, are associated with rheumatoid arthritis. Nat Genet. 2003, 34: 395-402. 10.1038/ng1206.CrossRefPubMed
34.
Barton A, Bowes J, Eyre S, Symmons D, Worthington J, Silman A: Investigation of polymorphisms in the PADI4 gene in determining severity of inflammatory polyarthritis. Ann Rheum Dis. 2005, 64: 1311-1315. 10.1136/ard.2004.034173.PubMedCentralCrossRefPubMed
35.
Ikari K, Kuwahara M, Nakamura T, Momohara S, Hara M, Yamanaka H, Tomatsu T, Kamatani N: Association between PADI4 and rheumatoid arthritis: a replication study. Arthritis Rheum. 2005, 52: 3054-3057. 10.1002/art.21309.CrossRefPubMed
36.
Kang CP, Lee HS, Ju H, Cho H, Kang C, Bae SC: A functional haplotype of the PADI4 genen associated with increased rheumatoid arthritis susceptibility in Koreans. Arthritis Rheum. 2006, 54: 90-96. 10.1002/art.21536.CrossRefPubMed
37.
Plenge RM, Padyukov L, Remmers EF, Purcell S, Lee AT, Karlson EW, Wolfe F, Kastner DL, Alfredsson L, Altshuler D, Gregersen PK, Klareskog L, Rioux JD: Replication of putative candidate-gene associations with rheumatoid arthritis in >4000 samples from North America and Sweden: association of susceptibility with PTPN22, CTLA4 and PADI4. Am J Hum Genet. 2005, 77: 1044-1060. 10.1086/498651.PubMedCentralCrossRefPubMed
38.
Caponi L, Petit-Teixeira E, Sebbag M, Bongiorni F, Moscato S, Pratesi F, Pierlot C, Osorio J, Chapuy-Regaud S, Guerrin M, Cornelis F, Serre G, Migliorini P, ECRAF: A family based study shows no association between rheumatoid arthritis and the PADI4 gene in a white French population. Ann Rheum Dis. 2005, 64: 587-593. 10.1136/ard.2004.026831.PubMedCentralCrossRefPubMed
Metadata
Title
Aspects of early arthritis. What determines the evolution of early undifferentiated arthritis and rheumatoid arthritis? An update from the Norfolk Arthritis Register
Authors
Deborah PM Symmons
Alan J Silman
Publication date
01-08-2006
Publisher
BioMed Central
Published in
Arthritis Research & Therapy / Issue 4/2006
Electronic ISSN: 1478-6362
DOI
https://doi.org/10.1186/ar1979

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