Change of diagnoses and outcome of patients with early inflammatory joint diseases during a mean 13‐month follow‐up

Abstract

Objective: To assess the state of the disease and verify the diagnoses during a 7–24‐month follow‐up of adult patients with newly diagnosed inflammatory joint diseases in a defined population.

Methods: Patients with previously undiagnosed synovitis in at least one peripheral joint or signs of inflammation in sacroiliac, glenohumeral or hip joints were enrolled on their first hospital visit in 2000 and followed‐up for up to 24 months in Kuopio.

Results: A total of 138/173 adult patients completed a mean 13‐month follow‐up. During the follow‐up the diagnosis was specified for 15/81 (19%) patients previously classified as undifferentiated arthritis (UA). Eight patients developed rheumatoid arthritis (RA). Of 28 patients with RA, 92% were on disease‐modifying anti‐rheumatic drugs (DMARDs) and 75% had a combination treatment with two or more DMARDs. According to the diagnosis at baseline, 75% of cases with RA, 38% with spondyloarthropathies (SpAs) and 42% with UA had active synovitis or arthralgia at follow‐up. In multivariate analysis, older patients at disease onset were less likely to be in remission (p = 0.011).

Conclusion: The diagnosis could be specified for 19% of patients with UA. Fifteen of 20 patients with RA had an active disease despite treatment with DMARDs. Patients with SpAs and UA had a better short‐term outcome. Patients with active disease need aggressive therapy in all age groups.