Predicting rapid radiographic progression in difficult-to-treat rheumatoid arthritis: insights from long-term follow-up
Authors' conclusion
In contrast, many D2T RA patients exhibited comparatively slow radiographic progression indicating that many D2T RA cases are at least partially treated.
Study context
- Population
- EULAR-defined difficult-to-treat RA (D2T RA) patients114 with serial radiographs
- Participants
- 254 participants
- Exposure
- Persistent inflammatory refractory RA (PIRRA) vs non-inflammatory refractory RA (NIRRA); Poly-refractory RA (pr-RA) vs other D2T RA
- PIRRAn = 43
- pr-RAn = 14
- Outcome
- Long-term radiographic progression (mSvdH units/year); rapid radiographic progression (RRP, ≥5 mSvdH units/year)
- Follow-up
- Mean 9 years
Methodological detailslong-term follow-up, serial radiographs, multivariable analysis
- Long-term follow-up
- Serial radiographs
- Multivariable analysis
Main finding
As reported in the abstract
Annual mSvdH progression
P = 0.025
- Mean annual modified Sharp/van der Heijde (mSvdH) progression, all D2T RA with serial radiographs
- 2.8 units
- Time-integrated CRP associated with significantly greater annual radiographic progression
- P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | pr-RA | Other D2T RA | P value |
|---|---|---|---|
| RRP, pr-RA vs other D2T RA (subgroup) | 50% | 19.4% | P = 0.048 |
Independent predictors of rapid radiographic progression (RRP) (multivariable analysis)
- Older age independently associated with RRP
- P = 0.017
- Swollen joint count independently associated with RRP
- P = 0.009
Original publication
Predicting rapid radiographic progression in difficult-to-treat rheumatoid arthritis: insights from long-term follow-up. Rheumatology (Oxford). Published 1 October 2025. doi:10.
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