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The Italian Registry of Aggressive Rheumatoid Arthritis — the GIARA Project
ANTONIO MARCHESONI, MARCELLO GOVONI, GABRIELE VALENTINI, GUIDO VALESINI, FAUSTO SALAFFI, PIERLUIGI MACCHIONI, ORNELLA DELLA CASA ALBERIGHI, GIANFRANCO FERRACCIOLI, and GIARA Members
ABSTRACT. Methods. For 1 year, all patients with RA for < 5 years and referred to participating centers were entered in a registry and classified as having ARA if they fulfilled the following criteria: 10 swollen joints for at least 6 weeks, positive rheumatoid factor (RF), and at least one bone erosion (if disease duration of 2 years); (a) RF-positive and having 10 swollen joints or at least one newly eroded joint, or (b) if RF-negative, having 10 swollen joints and at least one newly eroded joint (if disease duration > 2 to < 5 years). Results. The 94 participating centers enrolled 1218 patients with RA, 1130 of whom had enough data to be classified as ARA (29.0%) or non-ARA (71.0%). The frequency of ARA was 15% in the 2-year group and 63% in the > 2 to < 5-year group, but 35% of the patients in the 2-year group had erosions. Bone erosions were associated with disease duration, a Health Assessment Questionnaire value > 1.5, female sex, and RF positivity. Conditions other than RA were recorded in about 50% of the patients, and only 30%–40% were taking disease modifying antirheumatic drugs. Conclusion. In an Italian RA population, the GIARA (Gruppo Italiano Artrite Reumatoide Aggressiva) criteria for ARA were met by 15% of the patients with disease duration of 2 years, but erosions were seen in 35%. Upon referral, most of the RA patients were inadequately treated and had other conditions. (First Release Nov 15 2007; J Rheumatol 2007;34:2374-81) Key Indexing Terms:
RHEUMATOID ARTHRITIS
From the UOC Rheumatology Day Hospital, G. Pini Orthopaedic Institute, University of Milan, Milan; Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Ferrara, Ferrara; Department of Clinical and Experimental Internal Medicine, Second University of Naples, Naples; Department of Clinical Medicine and Therapy, UOC Rheumatology, Sapienza University, Rome; Department of Rheumatology, Marche Polytechnic University, Ancona; UOC Rheumatology, Arcispedale Santa Maria Nuova, Reggio Emilia; Clinical Pharmacology Unit, Gaslini Institute, IRCCS, Genoa; and Division of Rheumatology, Catholic University of the Sacred Heart, School of Medicine, Rome, Italy. Supported by an unrestricted grant from Novartis Farma SpA, Italy. A. Marchesoni, MD, G. Pini Orthopaedic Institute, University of Milan; M. Govoni, MD, Associate Professor of Rheumatology, University of Ferrara; G. Valentini, MD, Professor of Rheumatology, Second University of Naples; G. Valesini, MD, Professor of Rheumatology, Sapienza University; F. Salaffi, MD, Associate Professor of Rheumatology, Marche Polytechnic University; P. Macchioni, MD, Arcispedale Santa Maria Nuova; O. Della Casa Alberighi, MD, Gaslini Institute, IRCCS; G. Ferraccioli, MD, Professor of Rheumatology, Catholic University of the Sacred Heart, School of Medicine. Address reprint requests to Dr. A. Marchesoni, UOC Rheumatology Day Hospital, Istituto Ortopedico G. Pini, Via G. Pini 1, 20122 Milano, Italy. E-mail: marchesoni@gpini.it Accepted for publication August 24, 2007. |
