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Quantification and Impact of Secondary Osteoarthritis in Patients With Anti–Citrullinated Protein Antibody–Positive Rheumatoid Arthritis
Author(s) -
Figueiredo Camille P.,
Simon David,
Englbrecht Matthias,
Haschka Judith,
Kleyer Arnd,
Bayat Sara,
Hueber Axel,
Pereira Rosa M. R.,
Rech Juergen,
Schett Georg
Publication year - 2016
Publication title -
arthritis and rheumatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.106
H-Index - 314
eISSN - 2326-5205
pISSN - 2326-5191
DOI - 10.1002/art.39698
Subject(s) - medicine , rheumatoid arthritis , osteoarthritis , rheumatology , gastroenterology , logistic regression , multivariate analysis , confidence interval , cross sectional study , pathology , alternative medicine
Objective To search for evidence of secondary osteoarthritis (OA) in patients with rheumatoid arthritis (RA) in a cross‐sectional and longitudinal setting, and to relate osteophyte formation to functional outcome. Methods Anti–citrullinated protein antibody (ACPA)–positive RA patients underwent high‐resolution peripheral quantitative computed tomography of the hand. Cross‐sectional and longitudinal measurements were performed. The number and size (volume) of osteophytes as well as bone erosions were documented. The relationship of osteophytes to bone erosions and to demographic and disease‐specific data was evaluated by multiple logistic regression models. Results A total of 202 ACPA‐positive RA patients were enrolled in the cross‐sectional part of the study, and a total of 77 ACPA‐positive RA patients were enrolled in the longitudinal analysis (interval of 1.5 years between baseline and follow‐up assessment). The mean ± SD number of osteophytes per patient was 1.3 ± 2.3, and the mean ± SD osteophyte volume per patient was 2.6 ± 4.9 mm 3 . The total number of erosions was significantly correlated with the total number of osteophytes ( P < 0.001), and the total volume of erosions was significantly correlated with the total volume of osteophytes ( P < 0.001). Moreover, the number of osteophytes was related to age ( P < 0.001) and disease duration ( P = 0.001), while the volume of osteophytes was related to age ( P = 0.001), disease duration ( P < 0.001), and function as measured by the Health Assessment Questionnaire ( P = 0.013). Multivariate regression analyses showed an independent association between osteophytes and erosions. In the longitudinal analysis, the mean number ( P = 0.033) and volume ( P < 0.001) of osteophytes increased significantly in RA patients during their disease course. Conclusion Age, disease duration, and bone erosions are associated with osteophytes, indicating development of secondary OA in patients with RA.