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Forefoot disease activity in rheumatoid arthritis patients in remission results of a cohort study.doc

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Forefoot disease activity in rheumatoid arthritis patients in remission results of a cohort study

van der Leeden et al: Arthritis Research Therapy 2010, 12:R3 /content/12/1/R3 RESEARCH ARTICLE Open Access Forefoot disease activity in rheumatoid arthritis Research article patients in remission: results of a cohort study Marike van der Leeden*1, Martijn PM Steultjens1,2, Dirkjan van Schaardenburg3,4 and Joost Dekker1,2 Abstract Introduction: The aim of our study was to investigate the presence of disease activity in the metatarsophalangeal (MTP) joints of the forefoot in rheumatoid arthritis (RA) patients in remission according to the Disease Activity Score based on 28 joints (DAS28) remission criterion. Methods: A total of 848 patients with recent-onset RA were included from 1995 through 2007. The DAS28 and pain and swelling of the MTP joints were assessed annually. The data were analyzed using descriptive techniques. Results: On average, 35% of the patients fulfilled the remission criterion of DAS28 2.6 during the first eight years of RA. On average, 29% of these patients had at least one painful MTP joint and, on average, 31% had at least one swollen MTP joint during follow-up. Forty percent, on average, had at least one involved MTP joint (pain and/or swelling). Conclusions: Painful and/or swollen MTP joints were detected in a substantial proportion of patients classified as being in remission. Therefore, examination of the foot joints - irrespective of the patients state of remission - seems indicated in order to provide optimal foot care. Introduction Materials and methods Forefoot disease activity appears to be frequent in rheuma- Study design toid arthritis (RA). In a cohort of patients with recent-onset Since 1995, patients age 18 years with recent-onset arthri- RA and a maximum of eight years follow up, prevalence tis (peripheral arthritis of 2 joints and symptom duration rates for pain and swelling of the metatarsophalangeal less than three years) have been included in the early arthri- (MTP) joints were initially high and