A prospective study for outcome and prediction of early arthritis: a tertiary care centre observation

IntroductionEarly undifferentiated arthritis has varied outcome: majority remits spontaneously and about 1/3rdevolve into rheumatoid arthritis (RA).ObjectiveTo find out the clinical feature of early arthritis, its outcome, predictors of its evolution into rheumatoid arthritis and of its spontaneous remission and the outcome of treatment of early rheumatoid arthritis.MethodFifty-three patients (37 females) were recruited. Logistic-regression analysis was done to find out independent predictors of early arthritis evolving into RA or remitting spontaneously and the Receiving Operating Characteristic curve analysis was done to examine the validity of the Prediction rule.ResultAbout half of the patients had spontaneous remission and rest evolved into RA. The majority (31.4%) of patients with early arthritis presented with symmetric arthritis involving both upper and lower limbs. A low DAS28 (odds ratio 0.384, P=0.002) at presentation was the predictor of evolution into RA whereas anti-CCP antibody negativity (odds ratio 0.222, P= 0.044) was predictor of spontaneous resolution.ConclusionThe anti-CCP antibody predicted disease remission whereas low disease activity predicted disease persistence. Larger sample size with longer duration of follow-up is needed.