Supplementary MaterialsAdditional file 1: Table S1. data were used from patients included in the DREAM remission induction cohort. Patients received protocolized T2T treatment, aimed at 28-joint disease activity score-erythrocyte sedimentation rate (DAS28-ESR) remission. Disease activity (DAS28-ESR and C-reactive protein, CRP) were assessed at least every 3?months; X-rays of the hand and feet at inclusion, 6?months, and 1, 2, and 3?years were scored using modified Sharp/van der Heijde scoring (SHS). Between and within-person associations between time-integrated disease activity and radiographic progression over time were examined. Results A subset of 229 out of 534 included patients were available for analysis. At the between-patient level, time-integrated DAS28-ESR scores were not significantly correlated with progression at the 6?month and 2-year follow-up and only weakly at the 1-year (Pearsons correlation coefficient between 0.39 and 0.59; values ?0.001). Between 15.9 to 22.7% and 16.7 to 38.5% of patients with low and moderate time-integrated disease activity, respectively, experienced relevant (SHS ?3) radiographic progression at the different time intervals. Analyses using CRP showed similar results. Conclusions In early RA patients treated according to T2T, radiographic progression appears to be PHTPP an individually decided disease process, driven by factors other than consistent high disease activity. For Rabbit polyclonal to MAPT individual patients, the intra-patient relation between disease activity and cumulative radiographic damage during the first 6?months is a good indicator for this relation in later years. Trial registration Netherlands Trial Register NTR578, 12 January 2006. (%)229145 (63.3)Age, mean??SD years22957.5??15.0BMI, mean??SD kg/m222026.4??4.6Symptom duration, median (IQR) weeks22813.0 (8.0C26.0)RF positive, (%)228140 (61.4)Anti-CCP positive, body mass index, interquartile range, rheumatoid factor, American College of Rheumatology, disease activity score based on 28-joint count, erythrocyte sedimentation rate, C-reactive protein, visual analog scale, Health Assessment Questionnaire, Short-Form 36 Health Survey, physical component summary, mental component summary Disease activity as measured with the DAS28-ESR decreased quickly from a mean (SD) of 4.92 (1.13, em n /em ?=?229) at baseline to 2.83 (1.08, em n /em ?=?225) after 6?months of T2T. DAS28-ESR scores further decreased to 2.50 (1.01, em n /em ?=?220) after 1?year, 2.37 (0.98, em n /em ?=?208) after 2?years, and 2.40 (0.98, em n /em ?=?197) after 3?years of treatment. CRP scores showed a similar decrease over time, with mean scores decreasing from 18.6 (22.4, em n /em ?=?222) at baseline to 7.5 (12.1, em n /em ?=?226), 7.9 (10.8, em n /em ?=?216), 8.4 (12.5, em n /em ?=?210), and 8.2 (16.1, em n /em ?=?200) after 6?months, 1?year, 2?years, and 3?years, respectively. Mean time-integrated DAS28-ESR scores in the four time intervals decreased from 3.64 (0.97, em n /em ?=?229) in the first 6?months of treatment to 2.30 (1.04, em n /em ?=?224) between 6 and 12?months, 2.37 (0.86, em n PHTPP /em ?=?217) between 1 and 2?years, and 2.13 (0.91, em n /em ?=?206) between 2 and 3?years of treatment (Fig.?1). Mean time-integrated CRP scores were 9.62 (9.57, em n /em ?=?228), 6.51 (6.01, em n /em ?=?223), 7.40 (6.33, em n /em ?=?215), and 7.45 (8.24, em n /em ?=?207) at baselineC6?months, 6?monthsC1?year, 1C2?years, and 2C3?years, respectively. Open in a separate window Fig. 1 Mean standardized time-integrated DAS28 disease activity scores (from previous time point) versus mean cumulative SHS progression scores (from baseline). Error bars are 95% confidence intervals Mean (SD) SHS radiographic harm at baseline was 4.68 (9.24). Radiographic joint harm kept raising in the next period intervals, with suggest SHS (SD) development ratings of 2.11 (3.88, em n /em ?=?193), 1.32 (1.88, em n /em ?=?168), 1.85 (2.96, em n /em ?=?150), and 1.43 (2.90, em n /em ?=?148), respectively (Fig.?1). The amount of sufferers with relevant development (SHS ?3) in each one of the period intervals was 48 (25.0%), 28 (17.2%), 35 (23.3%), and 26 (17.8%), respectively. Inter-individual relationship between disease activity and result On the mixed group level, time-integrated DAS28-ESR scores weren’t correlated with radiographic progression on the 6 significantly?month as well as the 2-season follow-up in support of weakly on the 1-season and 3-season follow-up (Desk?2). Inter-individual correlations had been virtually identical for disease activity as assessed with CRP, with time-integrated CRP and radiographic development considerably getting, but weakly, correlated on the 2-season and 3-season follow-up assessments just (Desk?2). Comparable correlations were found when using the imputed data. (Additional?file?1: Table S1). Table 2 Between-person Pearson correlations between PHTPP standardized time-integrated (AUC) disease activity and radiological progression (from previous time point) for each time interval thead th rowspan=”1″ colspan=”1″ /th th rowspan=”1″ colspan=”1″ BaselineC6?months /th th rowspan=”1″ colspan=”1″ 6?monthsC1?12 months /th th rowspan=”1″ colspan=”1″ 1C2?years /th th rowspan=”1″ colspan=”1″ 2C3?years /th /thead DAS28-ESR0.060 ( em n /em ?=?192)0.170* ( em n /em ?=?164)0.109 ( em n /em ?=?150)0.209* ( em n /em ?=?146)CRP0.042 ( em n /em ?=?192)0.137 ( em n /em ?=?166)0.178* ( em n /em ?=?150)0.275** ( em n /em ?=?147) Open in a separate window * em P /em ? ?0.05; ** em P /em ? ?0.01. em n /em ?=?number of patients with an available time-integrated disease activity score and a radiographic progression score in the time interval A wide inter-individual variation between disease activity and radiologic progression was also apparent from the individual trajectory plots (Fig.?2). Most patients showed limited radiographic progression over time. However, others showed more radiographic progression even.