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Carpenter L, Nikiphorou E, Sharpe R, et al. Have radiographic progression rates in early rheumatoid arthritis changed? A systematic review and meta-analysis of long-term cohorts. Rheumatology (Oxford). 2016;55(6):1053-1065doi: 10.1093/rheumatology/kew004.
Carpenter, L., Nikiphorou, E., Sharpe, R., Norton, S., Rennie, K., Bunn, F., Scott, D. L., Dixey, J., & Young, A. (2016). Have radiographic progression rates in early rheumatoid arthritis changed? A systematic review and meta-analysis of long-term cohorts. Rheumatology (Oxford, England), 55(6), 1053-1065. https://doi.org/10.1093/rheumatology/kew004
Carpenter, Lewis, et al. "Have radiographic progression rates in early rheumatoid arthritis changed? A systematic review and meta-analysis of long-term cohorts." Rheumatology (Oxford, England) vol. 55,6 (2016): 1053-1065. doi: https://doi.org/10.1093/rheumatology/kew004
Carpenter L, Nikiphorou E, Sharpe R, Norton S, Rennie K, Bunn F, Scott DL, Dixey J, Young A. Have radiographic progression rates in early rheumatoid arthritis changed? A systematic review and meta-analysis of long-term cohorts. Rheumatology (Oxford). 2016 Jun;55(6):1053-1065. doi: 10.1093/rheumatology/kew004. Epub 2016 Mar 08. PMID: 26961746.
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Rheumatology (Oxford). 2016 Jun;55(6):1053-1065. doi: 10.1093/rheumatology/kew004. Epub 2016 Mar 08.

Have radiographic progression rates in early rheumatoid arthritis changed? A systematic review and meta-analysis of long-term cohorts.

Rheumatology (Oxford, England)

Lewis Carpenter, Elena Nikiphorou, Rachel Sharpe, Sam Norton, Kirsten Rennie, Frances Bunn, David L Scott, Josh Dixey, Adam Young

Affiliations

  1. Centre for Lifespan and Chronic Illness Research.
  2. Postgraduate Medicine, University of Hertfordshire, Hatfield.
  3. Psychology Department, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London.
  4. Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield.
  5. Department of Rheumatology, Kings College London, London.
  6. Department of Rheumatology, New Cross Hospital, Wolverhampton and.
  7. Postgraduate Medicine, University of Hertfordshire, Hatfield, Rheumatology Department, St Albans City Hospital, St Albans, UK [email protected].

PMID: 26961746 DOI: 10.1093/rheumatology/kew004

Abstract

OBJECTIVE: To evaluate, firstly, all published data on baseline and annual progression rates of radiographic damage from all longitudinal observational cohorts, and secondly, the association of standard clinical and laboratory parameters with long-term radiographic joint damage.

METHODS: A comprehensive search of the literature from 1975 to 2014, using PubMed, SCOPUS and Cochrane databases, identified a total of 28 studies that investigated long-term radiographic progression, and 41 studies investigating predictors of long-term radiographic progression. This was submitted and approved by PROSPERO in February 2014 (Registration Number: CRD42014007589).

RESULTS: Meta-analysis indicated an overall baseline rate of 2.02%, and a yearly increase of 1.08% of maximum damage. Stratified analysis found that baseline radiographic scores did not differ significantly between cohorts recruiting patients pre- and post-1990 (2.01% vs 2.03%; P > 0.01); however, the annual rate of progression was significantly reduced in the post-1990 cohorts (0.68% vs 1.50%; P < 0.05). High levels of acute phase markers, baseline radiographic damage, anti-CCP and RF positivity remain consistently predictive of long-term radiographic joint damage.

CONCLUSION: Critical changes in treatment practices over the last three decades are likely to explain the reduction in the long-term progression of structural joint damage. Acute phase markers and presence of RF/anti-CCP are strongly associated with increased radiographic progression.

© The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: [email protected].

Keywords: meta-analysis; predictive models; radiographic progression; rheumatoid arthritis; systematic review

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