| Abstract | OBJECTIVE: To evaluate the prognostic value of rheumatoid factor (RF), detected in the Waaler-Rose agglutination assay and by nephelometry, in patients with recent-onset rheumatoid arthritis (RA). METHODS: Consecutive patients with new-onset RA between 1993 and 1997 were followed for a median period of 4.7 years. Clinical data at baseline and drug use during the disease course were recorded. Outcome parameters studied were disease process, damage (erosions, joint surgery, extra-articular manifestations, and new co-morbidity), and death. Cut-off levels for RF were >40 IU/mL (nephelometry) and titres 1:160 (Waaler-Rose haemagglutination). RESULTS: RF tests were negative by both methods in 22% of RA patients (RF- group), while 33% were RF positive by nephelometry only (RF+ group) and 45% were positive by Waaler-Rose and nephelometry (RF++ group). Baseline clinical and laboratory findings as well as the number of subsequently used disease-modifying anti-rheumatic drugs (DMARDs), the number of patients starting and the time spent on steroid therapy were similar in the three RF groups. Odd ratios for death (n = 23), erosions (n = 62), and serious extra-articular disease manifestations (EAMs) (n = 13) as well as patient survival, erosion-free or surgery-free survival rates did not differ between the RF groups. Only rheumatoid nodules were more frequent in RF++ patients. CONCLUSION: The baseline presence of RF by either Waaler-Rose or nephelometry was not associated with differences in drug therapy, morbidity other than rheumatoid nodules, or mortality in RA patients in the first 5 years of disease. Being immunoglobulin M (IgM) RF positive thus had little impact on RA patient outcome. |
| Authors | C Nikolaisen, O P Rekvig, H C Nossent
(Affiliation: Department of Rheumatology, Institute of Clinical Medicine, University of Tromsø, Norway. cathrin.nikolaisen at unn.no)
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| Journal | Scandinavian journal of rheumatology
(Scand J Rheumatol)
2005 Jul-Aug
Vol. 34
Issue 4
Pg. 269-76
ISSN: 0300-9742 Norway |
| PMID | 16195159
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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| Chemical References |
- Antirheumatic Agents
- Biological Markers
- Rheumatoid Factor
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| Topics |
- Adult
- Aged
- Aged, 80 and over
- Agglutination Tests
(methods)
- Antirheumatic Agents
(therapeutic use)
- Arthritis, Rheumatoid
(diagnosis, drug therapy, mortality)
- Biological Markers
(analysis)
- Cohort Studies
- Confidence Intervals
- Disease Progression
- Female
- Humans
- Logistic Models
- Male
- Middle Aged
- Multivariate Analysis
- Nephelometry and Turbidimetry
(methods)
- Norway
- Prognosis
- Retrospective Studies
- Rheumatoid Factor
(analysis)
- Rheumatoid Nodule
(diagnosis, drug therapy, mortality)
- Risk Factors
- Sensitivity and Specificity
- Severity of Illness Index
- Survival Rate
- Time Factors
- Treatment Outcome
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