Factors Related to the Progression of Joint Destruction in Rheumatoid Arthritis

Abstract

In 103 (M=25, F=78) of 150 consecutive RA patients, values of the following variables were obtained at the start and end of a 2–year follow-up period: radiographic destruction score of hands and feet according to Larsen (Larsen index), Ritchie index, B-hemoglobin, ESR and plasma proteins (α_1-antitrypsin, ceruloplasmin, CRP, fibrinogen, haptoglobin, orosomucoid, IgA, IgG, IgM, C3 and C4). 60% of the values of ΔLI (final minus initial value of Larsen index) were significantly larger than zero (11–44 units, p<0.05). ΔLI was larger in females than in males (p=0.11). Comparing women with duration of disease (DoD) 1–6 years versus 7–52 years, ΔLI was larger in the former group (p=0.005). Comparing women with the largest ΔLI (19–44 units) with the remainder ones (ΔLI=-9–18 units), CRP and haptoglobin was higher and IgM lower in the former group (p=0.03, 0.02 and 0.03 respectively). In women with DoD 1–6 years (and only in this interval) significant linear relationships were found between ALI and hemoglobin (r-0.52, p<0.01) Ritchie index, haptoglobin, CRP (r=0.41–0.46, p<0.05) and IgM (r=-0.43, p<0.05). The mean of repeated hemoglobin values correlated even more strongly with ΔLI (r=0.70, p<0.001). ΔLI was predicted quite well by an expression linear in hemoglobin, fibrinogen and IgM (R=0.84). Similar results were obtained when male patients were included.