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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To identify factors present in recent onset arthritis that may help to predict rheumatoid arthritis &#40;RA&#41;&#44; and to describe a cohort of recent onset RA&#46;</p> <span class="elsevierStyleSectionTitle">Patients and method</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A 5 year prospective cohort of patients with early oligo and polyarthritis &#40;&#60;1 year of evolution&#41; from 34 rheumatology units&#44; was performed&#46; Sociodemographic&#44; clinical features&#44; and RA risk factors were recorded&#46; Rheumatoid factor &#40;RF&#41;&#44; anti-CCP determinations&#44; and radiographs of hands and feet were analyzed too&#46; After 3 years&#44; a diagnosis of certainty and the variables that determined the evolution to RA&#44; were evaluated&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">One hundred and seventy one patients were included&#59; 161 &#40;94&#46;2&#37;&#41; fulfilled RA diagnostic criteria&#59; most of them &#40;157&#59; 97&#46;5&#37;&#41; in the first visit&#46; Factors associated with RA diagnosis were&#58; positive RF&#44; anti-CCP&#44; and DAS-28&#59; 65&#37; of the patients had radiological erosions in the first visit&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Positive RF&#44; anti-CCP&#44; and the disease activity are predictive factors of RA&#46; Radiological damage exists very early in most of patients&#44; that&#39;s why it is more important to treat the disease aggressively instead than achieving an RA diagnosis of certainty</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento y objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Identificaci&#243;n de factores presentes en la artritis de reciente comienzo que puedan ayudar a predecir el desarrollo o no de artritis reumatoide &#40;AR&#41;&#46; Descripci&#243;n de las caracter&#237;sticas cl&#237;nicas de una cohorte de AR de inicio&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todo</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Cohorte de inicio prospectiva de 5 a&#241;os de duraci&#243;n en 34 servicios de reumatolog&#237;a espa&#241;oles formada por pacientes con oligoartritis y poliartritis de menos de un a&#241;o de evoluci&#243;n no tratados previamente&#46; A todos los pacientes se les realiz&#243; al inicio una valoraci&#243;n de la actividad inflamatoria&#44; capacidad funcional y factores de riesgo de AR&#46; Adem&#225;s se realizaron radiograf&#237;as de manos y pies y determinaciones de factor reumatoide &#40;FR&#41; y de anticuerpos anti-CCP&#46; Tras 3 a&#241;os&#44; se evalu&#243; el diagn&#243;stico definitivo y las variables que determinaron la evoluci&#243;n hacia AR&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se incluy&#243; a 171 pacientes&#44; de los que 161 &#40;94&#44;2&#37;&#41; acabaron cumpliendo criterios diagn&#243;sticos de AR&#44; la mayor&#237;a &#40;157&#59; 97&#44;5&#37;&#41; en la visita inicial&#46; Los factores relacionados con el diagn&#243;stico de AR fueron&#58; el FR positivo &#40;odds ratio &#91;OR&#93;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#44;5&#59; intervalo de confianza &#91;IC&#93; del 95&#37;&#44; 1&#8211;69&#44;8&#41;&#44; los anti-CCP &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#44;5&#59; IC del 95&#37;&#44; 0&#44;96&#8211;75&#44;7&#41; y el DAS28 &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;9&#59; IC del 95&#37;&#44; 1&#44;1&#8211;3&#44;3&#41;&#46; El 65&#37; de los pacientes presentaban erosiones en la visita basal&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Tanto la extensi&#243;n de la afecci&#243;n articular como tener un FR positivo y anticuerpos anti-CCP permiten predecir la evoluci&#243;n a AR&#46; El da&#241;o radiol&#243;gico&#44; en muchos pacientes&#44; ya est&#225; al inicio&#44; por lo que es m&#225;s importante un tratamiento contundente precoz que esperar a tener un diagn&#243;stico de AR&#46;</p>"
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Vol. 5. Issue 3.
Pages 115-120 (May - June 2009)
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Vol. 5. Issue 3.
Pages 115-120 (May - June 2009)
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What are patients with early rheumatoid arthritis like in Spain? Description of the PROAR cohort
¿Comó son los pacientes con artritis reumatoide de reciente comienzo en España? descripción de la cohorte PROAR?
Visits
5055
Virginia Villaverde Garcíaa, Alejandro Balsab,
Corresponding author
abalsa.hulp@salud.madrid.org

Corresponding author.
, Loreto Carmonac, Raimon Sanmartíd, Jesús Maesec, Dora Pascuale, José Ivorraf, Proar Group
a Unidad de Reumatología, Hospital de Móstoles, Móstoles, Madrid, Spain
b Servicio de Reumatología, Hospital La Paz, Madrid, Spain
c Unidad de Investigación, Fundación Española de Reumatología, Madrid, Spain
d Servicio de Reumatología, Hospital Clínic, Barcelona, Spain
e Servicio de Inmunología, Hospital La Paz, Madrid, Spain
f Servicio de Reumatología, Hospital Dr. Peset, Valencia, Spain
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Article information
Abstract
Objective

To identify factors present in recent onset arthritis that may help to predict rheumatoid arthritis (RA), and to describe a cohort of recent onset RA.

Patients and method

A 5 year prospective cohort of patients with early oligo and polyarthritis (<1 year of evolution) from 34 rheumatology units, was performed. Sociodemographic, clinical features, and RA risk factors were recorded. Rheumatoid factor (RF), anti-CCP determinations, and radiographs of hands and feet were analyzed too. After 3 years, a diagnosis of certainty and the variables that determined the evolution to RA, were evaluated.

Results

One hundred and seventy one patients were included; 161 (94.2%) fulfilled RA diagnostic criteria; most of them (157; 97.5%) in the first visit. Factors associated with RA diagnosis were: positive RF, anti-CCP, and DAS-28; 65% of the patients had radiological erosions in the first visit.

Conclusions

Positive RF, anti-CCP, and the disease activity are predictive factors of RA. Radiological damage exists very early in most of patients, that's why it is more important to treat the disease aggressively instead than achieving an RA diagnosis of certainty

Keywords:
Arthritis
Cohort studies
Early diagnosis
Autoimmune diseases
Resumen
Fundamento y objetivo

Identificación de factores presentes en la artritis de reciente comienzo que puedan ayudar a predecir el desarrollo o no de artritis reumatoide (AR). Descripción de las características clínicas de una cohorte de AR de inicio.

Pacientes y método

Cohorte de inicio prospectiva de 5 años de duración en 34 servicios de reumatología españoles formada por pacientes con oligoartritis y poliartritis de menos de un año de evolución no tratados previamente. A todos los pacientes se les realizó al inicio una valoración de la actividad inflamatoria, capacidad funcional y factores de riesgo de AR. Además se realizaron radiografías de manos y pies y determinaciones de factor reumatoide (FR) y de anticuerpos anti-CCP. Tras 3 años, se evaluó el diagnóstico definitivo y las variables que determinaron la evolución hacia AR.

Resultados

Se incluyó a 171 pacientes, de los que 161 (94,2%) acabaron cumpliendo criterios diagnósticos de AR, la mayoría (157; 97,5%) en la visita inicial. Los factores relacionados con el diagnóstico de AR fueron: el FR positivo (odds ratio [OR]=8,5; intervalo de confianza [IC] del 95%, 1–69,8), los anti-CCP (OR=8,5; IC del 95%, 0,96–75,7) y el DAS28 (OR=1,9; IC del 95%, 1,1–3,3). El 65% de los pacientes presentaban erosiones en la visita basal.

Conclusiones

Tanto la extensión de la afección articular como tener un FR positivo y anticuerpos anti-CCP permiten predecir la evolución a AR. El daño radiológico, en muchos pacientes, ya está al inicio, por lo que es más importante un tratamiento contundente precoz que esperar a tener un diagnóstico de AR.

Palabras clave:
Artritis
Estudios de cohortes
Diagnóstico precoz
Enfermedades autoinmunitarias
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