Assessment of long-term articular damage and function in rheumatoid arthritis patients

• Main Authors: Amira A. Shahin, Abdel Kawy A. Moghazy, Wessam E. Hamed
• Format: Article
• Language: English
• Published: Elsevier 2019-01-01
• Series: Egyptian Rheumatologist
• Online Access: http://www.sciencedirect.com/science/article/pii/S1110116418300528

Aim of the work: This study aimed to assess long-term articular damage and function in rheumatoid arthritis (RA) patients in relation to the type of treatment. Early disease modifying anti-rheumatic drug (DMARD) therapy has not been evaluated in this study. Patients and methods: One hundred and fifty RA patients (141 females and 9 males) with disease duration more than five years and disease activity score-28 (DAS-28) <3.2 were included in this study. Sixty patients received disease modifying anti-rheumatic drugs (DMARDs) (group A), 60 received DMARDs and corticosteroids (CS) (group B), and 30 patients received CS only (group C). The functional outcome was assessed using the Modified Health Assessment Questionnaire (MHAQ). The articular damage was measured by using Rheumatoid Arthritis Articular Damage (RAAD) Score. The van der Heijde modification of the Sharp erosion score was used to define the plain X-ray of both hands and feet. Results: The mean age of the patients was 49.3 ± 11.5 years, and disease duration was 12 ± 7.9 years. There was a significant difference between the RAAD, visual analogue scale and MHAQ scores among the three groups (p = 0.001), with higher score in group C followed by B. By using Multiple regression analysis to examine the relationship between RAAD score and other independent variables there was a significant association of the RAAD score with higher X-ray score (p < 0.001) and with patients taking steroids only (p = 0.001). Conclusion: Although, use of corticosteroids may help to control the disease activity, but it increases the risk of overall joint damage. Keywords: Rheumatoid arthritis, Articular damage, RAAD score, Modified health assessment questionnaire, Corticosteroids, DMARDs