Predictors of outcome in patients with oligoarthritis - Results of a protocol of intraarticular corticosteroids to all clinically active joints
Date
2001
Authors
Green, M.
Marzo-Ortega, H.
Wakefield, R.
Astin, P.
Proudman, S.
Conaghan, P.
Hordon, L.
Emery, P.
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Journal article
Citation
Arthritis and Rheumatism, 2001; 44(5):1177-1183
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Green, Michael ; Marzo‐Ortega, Helena ; Wakefield, Richard J. ; Astin, Paul ; Proudman, Susanna ; Conaghan, Philip G. ; Hordon, Lesley ; Emery, Paul
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Abstract
<h4>Objective</h4>To determine the outcome and the factors that predict the persistence of synovitis following intraarticular corticosteroid injections in patients with recent-onset oligoarthritis.<h4>Methods</h4>Fifty-one patients with < or =5 joints with synovitis (disease duration < or =12 months) were treated with intraarticular injections of methylprednisolone into all joints with clinical synovitis. Predictors of outcome were sought, with the primary end point a complete response (no synovitis on clinical examination) at 12 weeks.<h4>Results</h4>Patient's and physician's assessments of disease activity, the swollen joint count, and function (by Health Assessment Questionnaire) were all significantly improved at 12 weeks (P < 0.001). Twenty-nine patients (57%) were judged to have had a complete response at 2 weeks. The best predictor of response at 12 and 26 weeks was the presence or absence of synovitis at 2 weeks (P = 0.002 and P = 0.004, respectively). At 52 weeks of followup, nearly 50% of the patients still had evidence of synovitis.<h4>Conclusion</h4>Intraarticular corticosteroids are an effective treatment for early oligoarthritis, but there is still a high level of long-term morbidity. Failure to respond by 2 weeks indicates a high likelihood of persistent disease, and this is relevant when producing management guidelines and selecting patients for studies focusing on early intervention.
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Copyright © 2001 by the American College of Rheumatology