The evaluation of disease progression in rheumatoid arthritis with radiographic, clinic and laboratory parameters

RA is one of the most common autoimmune diseases, affecting about 1% of the world's population. It may cause disability, decreased quality of life and even death as a results of late of diagnosis and treatment. Early diagnosis of RA and prediction of the progression are important issues of intensive research recently.Effective treatments can be avoid morbidity and mortality by early diagnosis and prediction of progression.The aim of the our study was to investigate disease progression and factors affecting clinical, laboratory and radiological involvement in patients with RA whose disease duration less than 5 years. 41 RA patients were followed 6-months follow-up period. In addition 40 healthy volunteers were enrolled in the study.Each patient was evaluated at 0, 3 and 6 months with detailed physical examination, laboratory and radiological parameters.Duration of morning stiffness (min), activity and rest pain (VAS), patient and doctor global assesment (VAS) were questioned for clinical assessment. Number of tender and swollen joints were determined in detailed physical examination. DAS 28 calculated for disease activity. HAQ was used for functional assesment. Radiographs of hands were taken at the beginning and 6th month, MR imagings of the hands and wrists were performed at inclusion, 3rd month and 6th month. Radiographs of hands were scored according to modified Sharp Van Der Heijde method. MR images were scored according to OMERACT RAMRIS scoring system.Erosion scores in the radiography and MRI were found to be increased compared to the first visit and 6th months. detected by both radiography and MR imaging was observed at 6th months. Anti MCV was the only laboratory parameter that correlated to the radiographic erosions. Significant correlations were observed between Anti MCV, Anti CCP and RF antibodies during the study period. Erosion scores in the conventional radiography and MRI, were higher in Anti-MCV-positive patient group than the negative group at 6th month visit. In addition, Anti-MCV, anti CCP and RF-positive patient groups compared with negative groups showed a significant increase in Sharp VDH erosion scores troughout the follow up period.In the conclusion, our results suggested that Anti-CCP and Anti-MCV antibodies in the patients with RA are thought to be as indicators for the effectiveness of the treatment, besides of the diagnostic values. In contrast to anti MCV antibody, Anti CCP ve RF antibodies showed inconsistent correlation between the clinical and radiological parameters. There were significant correlations between the Anti MCV and especially radiographic erosion scores. Therefore, Anti-MCV may be an usefull predictor to identify the patients with poor radiological prognosis rather than early diagnosis of the disease.