The frequency and associated factors of erosive osteoarthritis in patients with rheumatoid arthritis

Year 2024, Volume: 41 Issue: 4, 733 - 737, 31.12.2024

Mete Pekdiker , İnan Korkmaz , Sertaç Ketenci

Abstract

Erosive osteoarthritis (EOA) is a deformative joint disease affecting small joints of hands that causes pain and disability, as does rheumatoid arthritis (RA). So, EOA may interfere with the assessment of RA disease activity. In this study, we aimed to determine the frequency and associated factors of EOA in patients with RA and pay attention to the overlap syndrome between RA and EOA. The electronic medical files of adult RA patients were reviewed retrospectively. Patients with another rheumatic diseases were excluded. Hand X-rays were read by two rheumatologists and one radiologist. Patients with RA were divided into two groups according to the presence of EOA. We totally analyzed 619 patients with a mean age of 54.2 years, and 82.8% of them were female. The 95.4% of patients had RA-type erosive changes according to the Modified Sharp Score. We found the frequency of EOA to be 6.3% in patients with RA. Erosive osteoarthritis was significantly higher in patients who had >50 years of age (p= 0.006), disease duration >10 years (p= 0.003), and anti-CCP negativity (p= 0.02) than in those without. In multivariable regression analysis, only age was the independent predictive factor for EOA (p<0.001) in RA patients. We published the frequency and associated risk factors of EOA in RA for the first time in literature. Rheumatologists should take EOA into account when making treatment decisions in middle aged/elderly RA population. Further prospective studies are needed to explain the linkage between RA and EOA.

Keywords

erosive osteoarthritis, rheumatoid arthritis, risk factor, overlap syndrome

References

• 1. Zhang W, Doherty M, Leeb BF, Alekseeva L, Arden NK, Bijlsma JW, et al. EULAR evidence-based recommendations for the diagnosis of hand osteoarthritis: report of a task force of ESCISIT. Ann Rheum Dis. 2009;68(1):8-17.
• 2. Marshall M, Nicholls E, Kwok WY, Peat G, Kloppenburg M, van der Windt D, et al. Erosive osteoarthritis: a more severe form of radiographic hand osteoarthritis rather than a distinct entity? Ann Rheum Dis. 2015;74(1):136-141.
• 3. Punzi L, Ramonda R, Sfriso P. Erosive Osteoarthritis. Best Pract Res Clin Rheumatol. 2004;18(5):739-758.
• 4. Ehrlich GE. Inflammatory osteoarthritis-I. The clinical syndrome. Journal of Chronic Diseases. 1972;25(6):317-328.
• 5. Belhorn LR, Hess EV. Erosive osteoarthritis. Seminars in Arthritis and Rheumatism. 1993;22(5):298-306.
• 6. Martel W, Stuck KJ, Dworin AM, Hylland RG. Erosive osteoarthritis and psoriatic arthritis: a radiologic comparison in the hand, wrist, and foot. Am J Roentgenol. 1980;134(1):125-135.
• 7. Smolen JS, Aletaha D, Barton A, Burmester GR, Emery P, Firestein GS, et al. Rheumatoid arthritis. Nat Rev Dis Primers. 2018;4:18001.
• 8. Fleming A, Benn R, Corbett M, Wood P. Early rheumatoid disease II. Patterns of joint involvement. Ann Rheum Dis. 1976;35(4):361-364.
• 9. Ruiz-Medrano E, Espinosa-Ortega HF, Arce-Salinas CA. The effect of concomitant hand osteoarthritis on pain and disease activity in patients with rheumatoid arthritis. Clin Rheumatol. 2019;38(10):2709-2716.
• 10. Lee YH, Tsou HK, Kao SL, Gau SY, Bai YC, Lin MC, et al. Patients With Rheumatoid Arthritis Increased Risk of Developing Osteoarthritis: A Nationwide Population-Based Cohort Study in Taiwan. Front Med (Lausanne). 2020;7:392.
• 11. Neogi T, Aletaha D, Silman AJ, Funovits J, Felson DT, Bingham 3rd CO, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2010;69(9):1580-1588.
• 12. van den Hoogen F, Khanna D, Fransen J, Johnson SR, Baron M, Tyndall A, et al. 2013 classification criteria for systemic sclerosis: an American College of Rheumatology/European League against Rheumatism collaborative initiative. Arthritis Rheum. 2013;65(11):2737-2747.
• 13. Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H; CASPAR Study Group. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum. 2006;54(8):2665-2673.
• 14. Huang K, Aggarwal R. Antisynthetase syndrome: A distinct disease spectrum. J Scleroderma Relat Disord. 2020;5(3):178-191.
• 15. Neogi T, Jansen TL, Dalbeth N, Fransen J, Schumacher HR, Berendsen D, et al. 2015 Gout Classification Criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheumatol. 2015;67:2557-2568.
• 16. Abhishek A, Tedeschi SK, Pascart T, Latourte A, Dalbeth N, Neogi T, et al. The 2023 ACR/EULAR Classification Criteria for Calcium Pyrophosphate Deposition Disease. Arthritis Rheumatol. 2023;75(10):1703-1713.
• 17. Sharp JT, Young DY, Bluhm GB, Brook A, Brower AC, Corbett M, et al. How many joints in the hands and wrists should be included in a score of radiologic abnormalities used to assess rheumatoid arthritis? Arthritis Rheum. 1985;28(12):1326-1335.
• 18. Verbruggen G, Veys EM. Numerical scoring systems for the anatomic evolution of osteoarthritis of the finger joints. Arthritis Rheum. 1996;39(2):308-320.
• 19. Kwok WY, Kloppenburg M, Rosendaal FR, van Meurs JB, Hofman A, Bierma-Zeinstra SMA. Erosive hand osteoarthritis: its prevalence and clinical impact in the general population and symptomatic hand osteoarthritis. Ann Rheum Dis. 2011;70(7):1238-1242.
• 20. Kazmers NH, Meeks HD, Novak KA, Yu Z, Fulde GL, Thomas JL, et al. Familial Clustering of Erosive Hand Osteoarthritis in a Large Statewide Cohort. Arthritis Rheumatol. 2021;73(7):440-447.
• 21. Linos A, Worthington JW, O'Fallon WM, Kurland LT. The epidemiology of rheumatoid arthritis in Rochester, Minnesota: a study of incidence, prevalence and mortality. Am J Epidemiol. 1980;111(1):87-98.
• 22. Crowson CS, Matteson EL, Davis JM 3rd, Gabriel SE. Contribution of Obesity to the Rise in Incidence of Rheumatoid Arthritis. Arthritis Care Res (Hoboken). 2013;65(1):71-77.
• 23. Stern AG, de Carvalho MR, Buck GA, Adler RA, Rao TP, Disler D, et al. Association of erosive hand osteoarthritis with a single nucleotide polymorphism on the gene encoding interleukin 1 β. Osteoarthritis Cartilage. 2003;11(6):394-402.
• 24. Zhu L, Chen P, Sun X, Zhang S. Associations between Polymorphisms in the IL-1 Gene and the Risk of Rheumatoid Arthritis and Systemic Lupus Erythematosus: Evidence from a Meta-Analysis. Int Arch Allergy Immunol. 2021;182(3):234-242.
• 25. Goldring MB, Otero M. Inflammation in osteoarthritis. Curr Opin Rheumatol. 2011;23(5):471-478.
• 26. Robinson WH, Lepus CM, Wang Q, Raghu H, Mao R, Lindstrom TM, et al. Low-grade inflammation as a key mediator of the pathogenesis of osteoarthritis. Nat Rev Rheumatol. 2016;12(10):580-592.
• 27. Peter JB, Pearson CM, Marmor L. Erosive osteoarthritis of the hands. Arthritis Rheum. 1966;9(3):365-388.
• 28. Katona G. Osteoarthritis-an inflammatory disease? Int J Tissue React. 1984:6(6):453-461.
• 29. Payet J, Goulvestre C, Bialé L, Avouac J, Wipff J, Job-Deslandre C, et al. Anticyclic Citrullinated Peptide Antibodies in Rheumatoid and Nonrheumatoid Rheumatic Disorders: Experience with 1162 Patients. J Rheumatol. 2014;41(12):2395-2402.
• 30. van Delft MAM, van Beest S, Kloppenburg M, Trouw LA, Ioan-Facsinay A. Presence of Autoantibodies in Erosive Hand Osteoarthritis and Association with Clinical Presentation. J Rheumatol. 2019;46(1):101-105.
• 31. Punzi L, Ramonda R, Oliviero F, Sfriso P, Mussap M, Plebani M, et al. Value of C reactive protein in the assessment of erosive osteoarthritis of the hand. Ann Rheum Dis. 2005;64(6):955-957.
• 32. Smolen JS, Landewé RBM, Bijlsma JWJ, Burmester GR, Dougados M, Kerschbaumer A, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis. 2020;79(6):685-699.
• 33. Avouac J, Guerini H, Wipff J, Assous N, Chevrot A, Kahan A. Radiological hand involvement in systemic sclerosis. Ann Rheum Dis. 2006;65(8):1088-1092.
• 34. Baron M, Lee P, Keyston EC. The articular manifestations of progressive systemic sclerosis (scleroderma). Ann Rheum Dis. 1982;41(2):147-152.
• 35. Aksoy A, Solmaz D, Can G, Cetin P, Balci A, Akar S et al. Increased Frequency of Hand Osteoarthritis in Patients with Primary Sjögren Syndrome Compared with Systemic Lupus Erythematosus. J Rheumatol. 2016;43(6):1068-1071.