Monoarthritis does not progress to rheumatoid arthritis
A study of patients with isolated monoarthritis indicates that they are not at risk for progression to rheumatoid arthritis, according to findings published in the December issue of the Journal of Rheumatology.
"Monoarthritis (MA) is inflammation in a single joint," Dr. Alain Saraux, of Hopital de la Cavale Blanche, Brest, France, and colleagues write. "Few prospective studies of outcomes in patients with early MA followed up since symptom onset are available."
The researchers studied a cohort of 270 patients with early arthritis, who were classified into three groups: those with a single episode of MA (MA, n = 27), those with MA and a past history of self-reported arthritis (MA + past, n = 23), and those with oligo- or polyarthritis (OA/PA, n = 220).
At 6-month intervals, the patients underwent evaluations that included a standardized examination, radiographs of the hands and feet, and standard laboratory tests for rheumatoid factors (RF), antiperinuclear factor (APF), antikeratin antibody (AKA), anticyclic citrullinated peptide antibody (anti-CCP), antinuclear antibodies (ANA), and HLA-AB-DR typing. The diagnosis was assessed by a hospital-based rheumatologist after a median follow-up of 30 months.
The investigators note that knee involvement was more common in the MA group than in the MA + past group (p < 0.03). Hand and metatarsophalangeal involvement was less common in the MA group.
"For both RF and anti-CCP, positive results were less common in the MA group than in the other two groups," Dr. Saraux and colleagues report. "No statistically significant differences were identified across the three groups for RF ELISA, AKA, HLA-DR4 haplotype, and positive HLA-B27 antigen."
None of the patients in the MA group were diagnosed with RA.
The MA group was less often prescribed disease modifying antirheumatic drugs (1/27) than the MA + past group (11/23) and the OA/PA group (108/220) (p < 0.0001).
"The MA group was clearly different from the other groups," the researchers conclude, "with a favorable outcome and no risk of progression to RA."
J Rheumatol 2007;34:2351-2357.
"For both RF and anti-CCP, positive results were less common in the MA group than in the other two groups," Dr. Saraux and colleagues report. "No statistically significant differences were identified across the three groups for RF ELISA, AKA, HLA-DR4 haplotype, and positive HLA-B27 antigen."
So, they followed these guys for 2 1/2 years.
How much do you want to bet they're Palindromic? There are people on the IPRS that went 10 years before it progressed. I wish these guys would study what's different about us.
Pip
I figured this out about JRA about two years ago! I've been saying, in a layman's lament, "Why can't she just have one big fat knee?????" Because ALL those kids get better on NSAIDS, maybe one injection. Smooth sailing for them after that.My child has not gotten better on NSAIDS. So not all the JRA kids get better on NSAIDS. There are several that I know of on biologics and DMARDS. It has not been smooth sailing for Danielle. She is on a DMARD (Plaquenil is a DMARD) and this is proving out to no longer be working very well for her. Many of the JRA kids that I know are also on pred and that is not an NSAID.
Not ALL kids get better on NSAIDS. If that were the case...we would have some pretty happy kids and moms.
Danielle has more than one joint involved, right?
NSAIDS did nothing for my daughter, either.