Predictors of radiological progression of rheumatoid arthritis while receiving conventional synthetic disease-modifying antirheumatic drugs

The aim of the work is to study the predictors of rheumatoid arthritis (RA) radiological progression while using conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). Materials and methods. 163 patients with RA who were prescribed csDMARD were included in the study. Most of them were female 141 (86.5 %); mean age was 50.1 ± 12.0 years, disease duration 37.5 ± 56.3 months. Rheumatoid factor (RF) was detected in 53.3 % of patients, and antibodies to cyclic citrullinated peptide (ACCP) – in 54.0 %. Logistic and linear regression were used to analyze independent risk factors for radiological progression of RA and results were expressed as odds ratio (OR). Statistical processing was carried out using SPSS 29.0 software. Results. During 2 years of study, radiological progression according to the OMERACT 4 criteria was observed in 104 patients (63.8 %): in 97 patients (59.5 %) according to the total van der Heijde’s Sharp score (SHS); 53 (32.5 %) – erosion scale; and 99 (60.7 %) – narrowing scale. The dynamics of the average values of the total SHS and its components (erosive and narrowing scales) were 11.50 ± 14.20 (р < 0.001), 3.29 ± 5.86 (р < 0.01) and 8.30 ± 15.90 (p < 0.001) respectively. The mean increase in total SHS was 5.75 per year, while 41 patients (25.2 %) had radiological remission. In multivariate and ROC analyses, higher titers of ACCP (OR 0.06 [0.05; 0.09]) and RF (OR 0.01 [0.002; 0.02]), as well as the patient’s global assessment by visual analogue scale (OR 0.15 [-0.02; 0.33]) were independently associated with the risk of radiological progression of RA. Conclusions. The radiological progression of RA is observed in 63.8 % of patients with undergoing csDMARDs therapy. Only one in four patients achieves radiological remission. Independent predictors of radiographic progression in patients with RA are higher titers of ACCP, RF and higher values of patient’s global assessment by visual analogue scale at baseline.