Outcome of Early Monoarthritis: A Followup Study
AYMERIC BINARD, SEYDOU ALASSANE, VALÉRIE DEVAUCHELLE-PENSEC, JEAN M. BERTHELOT, SANDRINE JOUSSE-JOULIN, GERARD CHALÉS, CATHERINE LE HENAFF, JEAN B. THOREL, SYLVIE HOANG, PIERRE YOUINOU, and ALAIN SARAUX
Methods. A cohort of 270 patients with undiagnosed arthritis of less than 1 year's duration was divided into 3 groups: single episode of MA (MA, n = 27), MA with a history of patient-reported arthritis (MA past, n = 23), and oligo- or polyarthritis (OA/PA, n = 220). At 6-month intervals, all patients underwent a standardized examination, radiographs, and standard laboratory tests including rheumatoid factors (RF), antiperinuclear factor (APF), antikeratin antibody (AKA), anticyclic citrullinated peptide antibody (anti-CCP), antinuclear antibodies, and HLA-AB-DR typing. After a median followup of 30 months, the diagnosis was evaluated by a hospital-based rheumatologist.
Results. Age and sex did not differ across the 3 groups. Knee involvement was more common in the MA group than in the MA past group (p < 0.03), whereas hand and metatarsophalangeal involvement was less common (p < 0.03 and p < 0.0001, respectively). RF and anti-CCP were less often positive in the MA group than in the MA past group (p < 0.02 and p < 0.001, respectively) and the OA/PA group (p < 0.02 and p < 0.03). No patient in the MA group received a diagnosis of rheumatoid arthritis (RA). RA was less common and disease modifying antirheumatic drugs were prescribed less often in the MA group than in the other 2 groups (p < 0.0001 for both comparisons).
Conclusion. The MA group was clearly different from the other groups, with a favorable outcome and no risk of progression to RA. (First Release Nov 1 2007; J Rheumatol 2007; 34:2351-7)
Key Indexing Terms:
From the Unit of Rheumatology and the Laboratory of Immunology, la Cavale Blanche Hospital, Brest Teaching Hospitals, Brest; Department of Rheumatology, Hôtel-Dieu Hospital, Nantes Teaching Hospitals, Nantes; Department of Rheumatology, Rennes Teaching Hospitals, Rennes; Department of Rheumatology, Morlaix Hospital, Morlaix; Department of Rheumatology, Lorient Hospital, Lorient; and Department of Rheumatology, Vannes Hospital, Vannes, France.
A. Binard, MD; S. Alassane, MD; V. Devauchelle-Pensec, MD; S. Jousse-Joulin MD; P. Youinou, MD, PhD; A. Saraux, MD, PhD, Unit of Rheumatology and Laboratory of Immunology, la Cavale Blanche Hospital, Brest Teaching Hospitals; J.M. Berthelot, MD, Department of Rheumatology, Hôtel-Dieu Hospital, Nantes Teaching Hospitals; G. Chalés, MD, PhD, Department of Rheumatology, Rennes Teaching Hospitals; C. Le Henaff, MD, Department of Rheumatology, Morlaix Hospital; J.B. Thorel, MD, Department of Rheumatology, Lorient Hospital; S. Hoang, MD, Department of Rheumatology, Vannes Hospital.
Address reprint requests to Prof. A. Saraux, Rheumatology Unit, Hôpital de la Cavale Blanche, BP 824, F-29609 Brest cedex, France. E-mail: Alain.Saraux@chu-brest.fr
Accepted for publication December 29, 2006.