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Does early seronegative arthritis develop into rheumatoid arthritis? A 10-year observational study

1, 2, 3, 4, 5, 6

 

  1. Department of Rheumatology, Central Hospital of Central Finland, Jyväskylä, Finland. kirsi.paalanen@ksshp.fi
  2. Department of Radiology, Central Hospital of Central Finland, Jyväskylä, Finland.
  3. Department of Rheumatology, Central Hospital of Central Finland, Jyväskylä, Finland.
  4. Department of Rheumatology, Central Hospital of Central Finland, Jyväskylä, Finland.
  5. Department of Rheumatology, Central Hospital of Central Finland, Jyväskylä, Finland.
  6. Department of Rheumatology, Central Hospital of Central Finland, Jyväskylä, Finland.

CER11071
2019 Vol.37, N°1
PI 0037, PF 0043
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PMID: 29998832 [PubMed]

Received: 02/01/2018
Accepted : 26/03/2018
In Press: 07/06/2018
Published: 18/01/2019

Abstract

OBJECTIVES:
To investigate the 10-year clinical course of patients with seronegative arthritis with the emphasis of reclassification of diagnoses when applicable.
METHODS:
A total of 1030 patients including 435 seronegative cases were classified as early RA in 1997-2005 at Jyväskylä Rheumatology Centre and prospectively scheduled for a ten-year follow-up. Clinical data from the follow-up visits and the case-reports until and including the 10-year visit or death, whichever happened earlier, were retrospectively collected and reviewed with re-classification of the cases when applicable. Descriptive statistics were used.
RESULTS:
Among the 435 seronegative cases (69 % women, baseline mean age was 59 years), 13 (13/435 [3%]) could be reclassified as seropositive or erosive RA: 4 turned seropositive (2 for ACPA and 2 for RF [> 2x reference level]) and 9 developed erosions typical for RA. Reclassification revealed 68 (16%) cases of polymyalgia rheumatica, 46 (11%) psoriatic arthritis, 45 (10%) osteoarthritis, 38 (8.7%) spondyloarthritis, 15 (3.4%) plausible reactive arthritis, 10 (2.3%) gout, 17 (3.9%) pseudogout, 6 (1.4%) paraneoplastic arthritis, 6 (1.4%) juvenile arthritis, 2 (0.5%) haemochromatosis, 3 (0.7%) ankylosing spondylitis, 2 (0.5%) giant cell arteritis, and 8 miscellaneous diagnoses. The other 140 patients (32%) could not be reclassified in any clear-cut diagnosis and had features of transient arthritis (n=41), seronegative spondyloarthritis (n=47), while 49 remained unspecified.
CONCLUSIONS:
Over a 10-year follow-up period, reclassification revealed significant heterogeneity in the diagnosis of seronegative RA. Therefore, seronegative arthritis should not be studied as a homogenous entity.

Rheumatology Article