Classifying Radiographic Progression Status in Early Rheumatoid Arthritis Patients

• Activity Number: 101
• Type: Topic Contributed
• Date/Time: Monday, August 9, 2004 : 10:30 AM to 12:20 PM
• Sponsor: WNAR
• Author(s): Grace S. Park*+ and Weng Kee Wong and Myungshin Oh and John T. Sharp and Richard H. Gold and Ken J. Bulpitt and Harold E. Paulus
• Companies: University of California, Los Angeles and University of California, Los Angeles and University of California, Los Angeles and University of Washington and University of California, Los Angeles and Kaiser Permanente, West LA and University of California, Los Angeles
• Keywords: joint damage ; early rheumatoid arthritis ; composite definition ; progression vs. nonprogression

Abstract

Various methods are used to measure radiographic joint damage in rheumatoid arthritis (RA), but determining proportions of responsive individuals is difficult. We discuss different ways to classify radiographic damage in individuals with RA as progressive or nonprogressive. We assessed damage by total Sharp score (TSS), erosion score (ES), and joint space narrowing score (JSNS) for 751 serial hand, wrist, and foot films of 190 early RA patients from the Western Consortium study followed 6-60 months (mean 31 months). The damage progression rate was estimated for each patient. Within- and between-individual variance, measurement error, and different approaches to classifying radiographic progression status were examined. The selected index defines nonprogression as an increase of 0.1*trimmed SRM (standardized response mean for the central 95% of the sample) for five of six measures (ES and JSNS for hands, wrists, feet). 59% of 190 were categorized as nonprogressors, and had significantly lower disease activity and more clinical improvement than progressors. We conclude that joint damage in RA patients can be classified as progressive or nonprogressive using a composite definition.