Evolution from early to difficult-to-treat rheumatoid arthritis: incidence and risk factors in the ERA uclouvain Brussels cohort
Authors' conclusion
Baseline radiographic damage, seropositivity, and high disease activity represent the major risk factors for the evolution from ERA to D2T-RA. Disease activity indices were consistently higher in D2T patients all along the five-year follow-up. In addition, D2T patients received higher GC doses and more commonly developed disease and treatment-related comorbidities.
Study context
- Population
- DMARD-naïve ERA patients (symptom duration ≤ 12 months), enrolled 2010–2019, single centre (ERA uclouvain Brussels cohort)M/F 109/282
- Participants
- 391 patients
- Exposure
- ERA patients who developed D2T-RA vs those who did not
- D2Tn = 41
- Outcome
- Development of D2T-RA (EULAR 2021 criteria)
- Follow-up
- 5 years
Methodological detailsmonocentric, univariate and multivariate logistic regression
- Monocentric
- Univariate and multivariate logistic regression
Main finding
As reported in the abstract
Incidence of D2T-RA
D2T
10.5%
41
Observational data: associations, not effects.
Further findings
| Outcome | OR (CI) | P value | |
|---|---|---|---|
| Baseline radiographic damage as independent factor for progression to D2T-RA (multivariate)Only factor confirmed in multivariate analysis | 2.38 (1.09–5.54) | P = 0.03 | |
| 0.20.5125Odds ratio (log scale) |
Baseline radiographic damage as independent factor for progression to D2T-RA (multivariate)
- Higher baseline radiographic damage, seropositivity and baseline disease activity in D2T patients
Disease activity during follow-up
- Consistently higher in the D2T group
Safety
GC exposure, infections and osteoporosis
- D2T patients exposed to higher GC dose and more commonly suffered infections and osteoporosis
Original publication
Evolution from early to difficult-to-treat rheumatoid arthritis: incidence and risk factors in the ERA uclouvain Brussels cohort. Arthritis Res Ther. Published 29 September 2025. doi:10.
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