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ORIGINAL ARTICLE
Year : 2010  |  Volume : 5  |  Issue : 3  |  Page : 106-111

A prospective study for outcome and prediction of early arthritis: a tertiary care centre observation


1 Departments of Rheumatology & Clinical Immunology, IPGMER & SSKM Hospital, Kolkata, India
2 Departments of Medicine, IPGMER & SSKM Hospital, Kolkata, India
3 Departments of Biochemistry, IPGMER & SSKM Hospital, Kolkata, India

Correspondence Address:
P Ghosh
Departments of Rheumatology & Clinical Immunology, IPGMER & SSKM Hospital, Kolkata
India
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Source of Support: None, Conflict of Interest: None


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Introduction: Early undifferentiated arthritis has varied outcome: majority remits spontaneously and about 1/3rd evolve into rheumatoid arthritis (RA). Objective: To find out the clinical feature of early arthritis, its outcome, predictors of its evolution into rheumatoid arthritis and of its spontaneous remission and the outcome of treatment of early rheumatoid arthritis. Method: Fifty-three patients (37 females) were recruited. Logistic-regression analysis was done to find out inde- pendent predictors of early arthritis evolving into RA or remitting spontaneously and the Receiving Operating Characteristic curve analysis was done to examine the validity of the Prediction rule. Result: About half of the patients had spontaneous remission and rest evolved into RA. The majority (31.4%) of patients with early arthritis presented with symmetric arthritis involving both upper and lower limbs. A low DAS28 (odds ratio 0.384, P = 0.002) at presentation was the predictor of evolution into RA whereas anti-CCP antibody neg- ativity (odds ratio 0.222, P = 0.044) was predictor of spontaneous resolution. Conclusion: The anti-CCP antibody predicted disease remission whereas low disease activity predicted disease persistence. Larger sample size with longer duration of follow-up is needed.


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