Year-end Sale % OFF 
Abstract
The objective of this study is to investigate if foot joint damage due to rheumatoid arthritis (RA) can predict whether patients will start wearing orthopaedic shoes (OS) within 10 years after treatment start. Data from recent onset RA patients with 10 years follow-up from the BeSt (Dutch acronym for treatment strategies) study were used. Treatment was tightly controlled, targeted at disease activity score (DAS) ≤2.4, according to 1 of 4 pre-specified treatment strategies. After 10 years of follow-up, orthopaedic shoe use was recorded in 285/508 patients (responders to questionnaires at 10 years). Between-group differences for orthopaedic shoe users and non-users were calculated at baseline, after 10 years, and change scores over the 10-year period were calculated. Predictors for orthopaedic shoe use were identified by univariable and multivariable logistic regression analyses. Orthopaedic shoe use was reported by 57/285 patients after 10 years. Orthopaedic shoe users had more joint damage, joint swelling and pain in the feet already at baseline and after 10 years. At both time points, DAS of orthopaedic shoe users and non-users was similar. Multivariable logistic regression showed that dichotomized foot erosions score (cut-off ≥1 erosion) (OR 2.42), anti-citrullinated protein antibodies (ACPA) (OR 4.64) and DAS (OR 1.77) were independent predictors of orthopaedic shoe use. Despite intensive targeted treatment, 57/285 recent onset RA patients started using orthopaedic shoes over 10 year of follow-up. Presence of foot erosions at treatment start predicts orthopaedic shoe use after 10 years. The risk of orthopedic shoe use increased for ACPA-positive patients and for those with higher baseline disease activity.Electronic supplementary materialThe online version of this article (doi:10.1007/s10067-015-3145-1) contains supplementary material, which is available to authorized users.
Highlights
Despite major improvements in the treatment of rheumatoid arthritis (RA) patients, joint damage is still a common disease manifestation
Responders were younger than non-responders (mean age 51.3 (SD 12.0) vs. 58.4 (SD 14.8) years, p < 0.001) and had a lower Health Assessment Questionnaire (HAQ) (mean 1.3 (SD 0.6) vs. 1.5 (SD 0.7), p = 0.020) but did not differ statistically significantly on gender, smoking status, anti-citrullinated protein antibodies (ACPA) positivity, baseline disease activity score (DAS), total Sharp/ van der Heijde score (SHS), total joint space narrowing (JSN) and total erosion scores (Supplementary Table 1)
This study showed that 57/285 (20 %) recent onset RA patients used orthopaedic shoes (OS) after 10 years of tightly controlled treatment
Summary
Despite major improvements in the treatment of rheumatoid arthritis (RA) patients, joint damage is still a common disease manifestation. The presence of erosions in an early disease stage is indicative of a potentially severe disease course with further joint damage progression [1, 2]. Several authors have reported that in recent onset RA patients, erosions and joint space narrowing (JSN) occur more frequently in the feet than in the hands, in the metatarsophalangeal joints [2,3,4,5]. Up to 80 % of RA patients reported disease-related feet problems, often already in an early disease stage (53 % of patients) [6]. Symptoms of the feet may disturb the gait pattern, thereby negatively affecting mobility and health-related quality of life [8, 9]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
