RESEARCH - Increased radiographic damage scores at onset of seropositive RA in older patients associated with OA

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Arthritis Rheum. 2005 Aug;52(8):2284-92.

Increased radiographic damage scores at the onset of seropositive rheumatoid

arthritis in older patients are associated with osteoarthritis of the hands,

but not with more rapid progression of damage.

Khanna D, Ranganath VK, Fitzgerald J, Park GS, Altman RD, Elashoff D, Gold

RH, Sharp JT, Furst DE, us HE.

University of California at Los Angeles, University of Cincinnati, and VAMC,

Cincinnati, Ohio.

OBJECTIVE: To investigate the impact of patient age at symptom onset on

radiographic joint damage at study entry, and on subsequent progression of

damage in a cohort of patients with early seropositive rheumatoid arthritis

(RA). METHODS: We studied 186 patients with RA of <15 months' duration. All

patients had active disease and had not received disease-modifying

antirheumatic drugs. At study entry and during followup, total Sharp scores

(TSS), RA-associated joint space narrowing (RA-JSN), and erosions were

determined on hand and foot radiographs. Baseline radiographs were also

scored for osteoarthritis (OA)-related JSN (OA-JSN) and osteophytes. Older

patients (>55 years) and younger patients (</=55 years) were compared by

t-test, Mann-Whitney U test, chi-square, or Fisher's exact test. Multiple

linear regression models were also constructed. RESULTS: The older group (n

= 74) had a higher baseline total Sharp score (median 6.21) compared with

the younger group (n = 112) (median 2.33) (P = 0.0002). This was mainly due

to a higher baseline JSN score in the older group (median 3.96 versus 1.08)

and not to differences in erosion score (median 0.91 versus 0.70). Disease

activity and duration of RA symptoms were similar in the 2 groups, as were

progression rates of the TSS, JSN score, and erosion score. At baseline, 26%

of patients had osteophytes, with a prevalence of 13% in the younger age

group and 50% in the older group. The presence of OA-JSN was highly

correlated with the presence of osteophytes (r = 0.72). Also, increased age

and RA-JSN were associated with increased severity of osteophytes and OA-JSN

at baseline. Multiple linear regression analysis showed that both age and

hand osteophytes contributed to the increase in baseline RA-JSN score and

TSS, but not to erosion score.

CONCLUSION: In a cohort of patients with early RA, an increase in the

baseline RA-JSN score and TSS can be accounted for in part by the presence

of hand OA.

PMID: 16052588

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

6052588 & dopt=Abstract

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