Repair of Radiographic Joint Damage Following Treatment with Etanercept in Psoriatic Arthritis Is Demonstrable by 3 Radiographic Methods

2011 ◽  
Vol 38 (6) ◽  
pp. 1066-1070 ◽  
Author(s):  
LIHI EDER ◽  
VINOD CHANDRAN ◽  
DAFNA D. GLADMAN
Keyword(s):  
Psoriatic Arthritis ◽  
Scoring System ◽  
Joint Space Narrowing ◽  
Joint Damage ◽  
Joint Space ◽  
Radiographic Assessment ◽  
Radiographic Damage ◽  
Erosion Score ◽  
Sharp Score ◽  
Hands And Feet

Objective.Psoriatic arthritis (PsA) is characterized by varied radiographic features. We describe a patient with PsA with severe radiographic damage that improved significantly following treatment with etanercept. The improvement was documented by several methods of radiographic assessment.Methods.Etanercept was introduced in September 2005. Radiographs of the hands and feet were read using 3 methods: the modified Steinbrocker method, the van der Heijde (vdH) modification of the Sharp method, and the Ratingen scoring system.Results.In July 2009, radiographs of the hands and feet showed improvement in erosion score and joint space narrowing, while bony proliferation remained the same [43 by modified Steinbrocker, 26 by the vdH Sharp score (12 for erosions and 14 for joint space narrowing), and 56 by the Ratingen (18 for erosion and 38 for proliferation].Conclusion.The 3 radiographic methods were useful in demonstrating improvement in joint scores. The modified Steinbrocker method, which is the simplest, was able to reveal improvement in our patient.

Psoriatic Nail Dystrophy Is Associated with Erosive Disease in the Distal Interphalangeal Joints in Psoriatic Arthritis: A Retrospective Cohort Study

2019 ◽  
Vol 46 (9) ◽  
pp. 1097-1102 ◽  
Author(s):  
Anna S. Antony ◽  
Andrew Allard ◽  
Adwaye Rambojun ◽  
Christopher R. Lovell ◽  
Gavin Shaddick ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Joint Space Narrowing ◽  
Joint Space ◽  
Joint Disease ◽  
Nail Dystrophy ◽  
Chi Square ◽  
Convenience Sample ◽  
Radiographic Damage ◽  
Erosive Disease ◽  
Distal Interphalangeal

Objective.To assess whether the association between psoriatic nail dystrophy and radiographic damage in the hands of patients with psoriatic arthritis (PsA) is specific to the distal interphalangeal (DIP) joints.Methods.A convenience sample of patients was collated from the Bath longitudinal PsA cohort. All patients had PsA according to the ClASsification for Psoriatic ARthritis criteria (CASPAR) criteria, scored radiographs of their hands, and documented nail scores as measured by the Psoriatic Nail Severity Score. Chi-square tests were performed to examine for association between features of nail dystrophy and radiographic damage in the DIP joints, and proximal interphalangeal or metacarpophalangeal (non-DIP) joints of the corresponding digits.Results.There were 134 patients included, with a median age of 53 years (interquartile range; IQR 44–61) and disease duration of 7 years (IQR 3–17). The presence of any form of psoriatic nail dystrophy was associated with erosion at the DIP joints of the corresponding digit (OR 1.9, 95% CI 1.23–2.83; p < 0.004) and this association was primarily driven by the presence of nail onycholysis (OR 1.72; 95% CI 1.12–2.62; p = 0.02). Nail subungual hyperkeratosis was more strongly associated with joint space narrowing, erosions, and osteoproliferation at the corresponding DIP joint compared to non-DIP joints (p < 0.001). Nail pitting was not associated with erosions or osteoproliferation.Conclusion.The presence of psoriatic nail dystrophy, particularly onycholysis, is associated with erosive disease at the DIP joints. Subungual hyperkeratosis is more strongly associated with erosive damage at the DIP than non-DIP joints. These findings support the anatomical and pathological link between nail and DIP joint disease.

SAT0031 CORRELATION BETWEEN IRREVERSIBLE PHYSICAL DISABILITY AND JOINT DAMAGE IN RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 945-946
Author(s):  
E. Cipolletta ◽  
A. Incorvaia ◽  
R. Mashadi Mirza ◽  
A. DI Matteo ◽  
M. Tardella ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Remission ◽  
Physical Disability ◽  
Scoring System ◽  
Disease Duration ◽  
Cartilage Damage ◽  
Joint Damage ◽  
Erosion Score ◽  
Hands And Feet ◽  
And Cartilage

Background:In rheumatoid arthritis (RA), irreversible physical disability appears to be more clearly associated with cartilage damage rather than with bone erosions (BE) using conventional radiography (CR) imaging.Objectives:To investigate the correlation between the ultrasound (US) and CR findings indicative of joint damage and irreversible physical disability in patients with RA in sustained clinical remission.Methods:Patients in sustained clinical remission according to the Simplified Disease Activity Index (SDAI)≤3.3 for at least 6 months were enrolled. The following data were regireted: age, disease duration, anti-cyclic citrullinated peptide (ACPA) antibody and rheumatoid factor (RF) status, Health Assessment Questionnaire (HAQ), CR of hands and feet [evaluated using the Simple Erosion Narrowing Score (SENS) method]. A standardized US examination was carried out to investigate the presence of BE (lateral side of II metacarpophalangeal, V metacarpophalangeal and V metatarsophalangeal joints and ulnar styloid) and of cartilage damage (II to V metacarpal heads), bilaterally. BE and cartilage damage were assessed according to OMERACT definitions. A semiquantitative scoring system for both BE (1) and cartilage damage (2) was adopted.Results:Ninety patients were consecutively enrolled. Average time for US evaluation was 10±2 minutes. Both SENS-JSN and US score of cartilage damage (US-CD) were significantly associated with irreversible disability (R=0.39, p<0.01 and R=0.46, p<0.01). US and CR showed a moderate agreement in the evaluation of cartilage damage (kappa=0.52, 95% confidence interval: 0.44-0.61).Figure 1.shows the association between disability and structural damage (A: US-CD, B: US-BE, C: SENS-JSN and D: SENS-BE). After adjusting for confounding factors (age, disease duration, ACPA and RF status, SENS-BE and US-BE) cartilage damage was the only significant predictor of irreversible disability both using CR (R2=0.31, adjusted R2=0.26, standardized β=0.36, p<0.01) and US (R2=0.31, adjusted R2=0.26, standardized β=0.34, p<0.01).Conclusion:This study supports the hypothesis that cartilage damage is more relevant than BE in determining irreversible disability in RA. Our data provide further evidence in favor of the external validity of US in the assessment of cartilage damage.References:[1] Ohrndorf S, Messerschmidt J, Reiche BE, et al. Evaluation of a new erosion score by musculoskeletal ultrasound in patients with rheumatoid arthritis: is US ready for a new erosion score? Clin Rheumatol. 2014;33:1255-62.[2] Mandl P, Studenic P, Filippucci E, et al. Development of semiquantitative ultrasound scoring system to assess cartilage in rheumatoid arthritis. Rheumatology (Oxford). 2019;58:1802-11.Disclosure of Interests:Edoardo Cipolletta: None declared, Antonella Incorvaia: None declared, Riccardo Mashadi Mirza: None declared, Andrea Di Matteo Grant/research support from: the publication was conducted while Dr. Di Matteo was an ARTICULUM fellow, Marika Tardella: None declared, Walter Grassi Speakers bureau: Prof. Grassi reports personal fees from AbbVie, personal fees from Celgene, personal fees from Grünenthal, personal fees from Pfizer, personal fees from Union Chimique Belge Pharma, outside the submitted work., Emilio Filippucci Speakers bureau: Dr. Filippucci reports personal fees from AbbVie, personal fees from Bristol-Myers Squibb, personal fees from Celgene, personal fees from Roche, personal fees from Union Chimique Belge Pharma, personal fees from Pfizer, outside the submitted work.

scholarly journals Usefulness of Ultrasound Imaging in Detecting Psoriatic Arthritis of Fingers and Toes in Patients with Psoriasis

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Clara De simone ◽  
Giacomo Caldarola ◽  
Magda D'Agostino ◽  
Angelo Carbone ◽  
Cristina Guerriero ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Joint Space Narrowing ◽  
Joint Damage ◽  
Joint Space ◽  
New Bone Formation ◽  
Chronic Plaque Psoriasis ◽  
X Ray ◽  
Dermatology Clinic ◽  
Soft Tissue Swelling ◽  
Psa Progression

Background. Given that clinical evaluation may underestimate the joint damage and that early treatment can slow down psoriatic arthritis (PsA) progression, screening psoriasis patients with imaging tools that can depict early PsA changes would entail clear benefits.Objective. To compare the ability of X-ray and ultrasound (US) examination in detecting morphological abnormalities consistent with early PsA in patients with psoriasis, using rheumatological evaluation as the gold standard for diagnosis.Methods. Patients with chronic plaque psoriasis and no previous PsA diagnosis attending our outpatient dermatology clinic and reporting finger/toe joint and/or tendon pain underwent X-ray and US evaluation; they were subsequently referred to a rheumatologist for clinical examination and review of imaging findings.Results. Abnormal US and/or X-ray findings involving at least one finger and/or toe (joints and/or tendons) were seen in 36/52 patients: 11 had one or more X-ray abnormalities, including erosion, joint space narrowing, new bone formation, periarticular soft tissue swelling, and periarticular osteoporosis; 36 had suspicious changes on US.Conclusion. US proved valuable in detecting joint and/or tendon abnormalities in the fingers and toes of patients with suspicious changes. The dermatologist should consider US to obtain an accurate assessment of suspicious findings.

scholarly journals Validity and Responsiveness of Combined Inflammation and Combined Joint Damage Scores Based on the OMERACT Rheumatoid Arthritis MRI Scoring System (RAMRIS)

2019 ◽  
Vol 46 (9) ◽  
pp. 1222-1227 ◽  
Author(s):  
Ulf Sundin ◽  
Mikkel Østergaard ◽  
Daniel Glinatsi ◽  
Anna-Birgitte Aga ◽  
Kim Hørslev-Petersen ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Scoring System ◽  
Bone Marrow Edema ◽  
Joint Space Narrowing ◽  
Joint Damage ◽  
Patient Characteristics ◽  
Joint Space ◽  
Damage Score ◽  
Derivation Cohort ◽  
Magnetic Resonance Imaging Mri

Objective.The RAMRIS [Outcome Measures in Rheumatology rheumatoid arthritis (RA) magnetic resonance imaging (MRI) Scoring system] is used in clinical RA trials. We have investigated methods to combine the RAMRIS features into valid and responsive scores for inflammation and joint damage.Methods.We used data from 3 large randomized early RA trials to assess 5 methods to develop a combined score for inflammation based on RAMRIS bone marrow edema, synovitis, and tenosynovitis scores, and a combined joint damage score based on erosions and joint space narrowing. Methods included unweighted summation, normalized summation, and 3 different variants of weighted summation of the RAMRIS features. We used a derivation cohort to calculate summation weights to maximize the responsiveness of the combined score. Construct validity of the combined scores was examined by assessing correlations to imaging, clinical, and biochemical measures. Responsiveness was tested by calculating the standardized response mean (SRM) and the relative efficiency of each score in a validation cohort.Results.Patient characteristics, as well as baseline and followup RAMRIS scores, were comparable between cohorts. All combined scores were significantly correlated to other imaging, clinical, and biochemical measures. Inflammation scores combined by normalized and weighted summation had significantly higher responsiveness in comparison to unweighted summation, with SRM (95% CI) for unweighted summation 0.62 (0.51–0.73), normalized summation 0.73 (0.63–0.83), and weighted summation 0.74 (0.64–0.84). For the damage score, there was a trend toward higher responsiveness for weighted summation.Conclusion.Combined MRI scores calculated by normalized or weighted summation of individual MRI pathologies were valid and responsive.

Construct Validity of Radiographs of the Feet to Assess Joint Damage in Patients with Gout

2016 ◽  
Vol 44 (1) ◽  
pp. 91-94 ◽  
Author(s):  
Bart Spaetgens ◽  
Caroline van Durme ◽  
Casper Webers ◽  
An Tran-Duy ◽  
Thea Schoonbrood ◽  
...  
Keyword(s):  
Construct Validity ◽  
Joint Space Narrowing ◽  
Disease Duration ◽  
Negative Binomial ◽  
Joint Damage ◽  
Joint Space ◽  
Factors Associated ◽  
Erosion Score ◽  
Method Factors ◽  
Linear Regressions

Objective.To investigate construct validity of radiographic damage of the feet in gout.Methods.Radiographs of the feet were scored using the Sharp/van der Heijde method. Factors associated with damage were investigated by a negative binomial model, and contribution of damage to health by linear regressions.Results.Age, disease duration, serum uric acid, and tophi were associated with being erosive and erosion score. Tophi were associated with joint space narrowing. Erosions were associated (β 0.47, 95% CI 0.09–0.84) with physical function, but damage was not associated with overall physical health.Conclusion.Our results support construct validity for radiographs of the feet when assessing joint damage in gout.

Influence of gender on assessments of disease activity and function in early rheumatoid arthritis in relation to radiographic joint damage

2009 ◽  
Vol 69 (01) ◽  
pp. 230-233 ◽  
Author(s):  
M Ahlmén ◽  
B Svensson ◽  
K Albertsson ◽  
K Forslind ◽  
I Hafström
Keyword(s):  
Disease Activity ◽  
Pain Perception ◽  
Joint Destruction ◽  
Joint Damage ◽  
Area Under The Curve ◽  
Joint Space ◽  
Joint Disease ◽  
Similar Degree ◽  
Sharp Score ◽  
Hands And Feet

Objective:To evaluate gender differences in score on 28-joint Disease Activity Score (DAS28), Health Assessment Questionnaire (HAQ) and Signals Of Functional Impairment (SOFI) and to relate these scores to radiographic joint destruction.Methods:In all, 549 patients with early RA (62% women) from the BARFOT (for “Better Anti-Rheumatic FarmacOTherapy”) study were included. At baseline, 1, 2 and 5 years DAS28, HAQ and SOFI scoring, and radiographs of hands and feet were performed. The radiographs were scored using the van der Heijde–Sharp score.Results:In women the DAS28 was significantly higher than in men due to higher scores for general health and tender joints. Likewise, HAQ and VAS pain were rated significantly higher in women. The SOFI score was worse in men during the first 2 years, depending on higher upper limb scores. Total Sharp score (TotSharp), erosion score and joint space narrowing score did not differ between the sexes at any time point. The DAS28 area under the curve (AUC) correlated significantly with TotSharp at 5 years in both genders (r = 0.316, r = 0.313) mainly owing to swollen joints and erythrocyte sedimentation rate (ESR). The SOFI AUC correlated significantly with TotSharp in women (r = 0.135 to 0.220) but not in men.Conclusions:Despite a similar degree of radiographic joint destruction women had, compared with men, worse scores for DAS28 and HAQ, possibly due to higher pain perception and less muscular strength and perhaps because men overestimate their functional capacity.

Clinical synovitis in a particular joint is associated with progression of erosions and joint space narrowing in that same joint, but not in patients initially treated with infliximab

2010 ◽  
Vol 69 (12) ◽  
pp. 2107-2113 ◽  
Author(s):  
N B Klarenbeek ◽  
M Güler-Yüksel ◽  
D M F M van der Heijde ◽  
H M J Hulsmans ◽  
P J S M Kerstens ◽  
...  
Keyword(s):  
Joint Space Narrowing ◽  
Clinical Signs ◽  
Joint Damage ◽  
Treatment Strategies ◽  
Joint Space ◽  
X Rays ◽  
Joint Level ◽  
Damage Progression ◽  
The Individual ◽  
Hands And Feet

ObjectivesTo assess the relationship between joint tenderness, swelling and joint damage progression in individual joints and to evaluate the influence of treatment on these relationships.MethodsFirst-year data of the Behandel Strategieën (BeSt) study were used, in which patients recently diagnosed as having rheumatoid arthritis (RA) were randomly assigned into four different treatment strategies. Baseline and 1-year x-rays of the hands and feet were assessed using the Sharp–van der Heijde score (SHS). With generalised estimating equations, 3-monthly assessments of tender and swollen joints of year 1 were related to erosion progression, joint space narrowing (JSN) progression and total SHS progression at the individual joint level (definition >0.5 SHS units) in year 1, corrected for potential confounders and within-patient correlation for multiple joints per patient.ResultsDuring year 1, 59% of all 13 959 joints analysed were ever tender and 45% ever swollen, 2.1% showed erosion progression, 1.9% JSN progression and 3.6% SHS progression. Swelling and tenderness were both independently associated with erosion and JSN progression with comparable OR, although with higher OR in the hands than in the feet. Local swelling and tenderness were not associated with local damage progression in patients initially treated with infliximab.ConclusionClinical signs of synovitis are associated with erosion and JSN progression in individual joints after 1 year in RA. A disconnect between synovitis and joint damage progression was observed at joint level in patients who were treated with methotrexate and infliximab as initial treatment, confirming the disconnect between synovitis and the development of joint damage in tumour necrosis factor blockers seen at patient level.

scholarly journals AB0134 RELATIONSHIP BETWEEN INFLAMMATORY RATIOS AND RADIOGRAPHIC JOINT DAMAGE IN RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1095.2-1095
Author(s):  
F. Maatoug ◽  
M. Slouma ◽  
R. Dhahri ◽  
O. Beskri ◽  
I. Gharsallah ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Structural Damage ◽  
Joint Space Narrowing ◽  
Joint Damage ◽  
Joint Space ◽  
Albumin Ratio ◽  
Sharp Score ◽  
The Mean ◽  
Modified Sharp Score ◽  
Joint Erosion

Background:The tight control strategy is recommended in rheumatoid arthritis to tailor treatment for patients. This strategy requires regular monitoring of both disease activity and structural damage. However, radiographic assessement cannot be performed frequently and the modified Sharp score is rarely evaluated in current practice. Besides, no biomarker was able to mirror structural damage (1).Objectives:Our study aimed to assess the relationship between the modified Sharp score and the inflammatory ratios (platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), fibrinogen to albumin ratio (FAR) and CRP to albumin ratio (CAR)).Methods:We performed a cross-sectional study including 53 patients with rheumatoid arthritis (RA). A cell blood count, fibrinogen and an albumin blood test were measured for each patient. Inflammatory ratios were also measured (PLR, NLR, LMR, FAR, and CAR). Modified Sharp score and its components (erosion score and joint space narrowing score) were evaluated using the radiograph of hand and foot.Patients with infectious or hematological diseases were excluded from the study.Statistical analysis was performed using SPSS (Statistical Package for Social Sciences).Results:Of the 53 patients, 39 were female (Sex Ratio: 2.8). The mean age was 53.9 ± 12.7 years. The mean disease duration was 10.1 ± 8.2 years.The average age of the onset of the disease was 43.8±13.5 years.The mean DAS 28-ESR score was 4.64 ± 1.23. Forty three patients had a score higher than 3.2 (patients with moderate or high disease activity).The mean values of PLR, NLR, LMR, FAR and CAR were 161.62 ± 86.59, 2.84 ± 2.39, 4.99 ± 3.23, 0.12 ± 0.06 and 1.15 ± 1.38.The mean scores of joint erosion and joint space narrowing were respectively 12.76 ± 15.05 and 33.57 ± 25.80. The mean modified Sharp score was 46.33 ± 37.74.There was a positive correlation between modified Sharp score and following ratios: PLR (r: 0.501; p <10-3), NLR (r: 0.302; p:0.031), FAR (r: 0.300; p:0.030), CAR (r:0.286; p:0.042).Moreover, a positive correlation between joint space narrowing score and these ratios was identified: PLR (r: 0.558; p <10-3), NLR (r: 0.428; p:0.002), FAR (r: 0.371; p:0.007), CAR (r:0.387; p:0.005).Joint erosion score correlated with PLR (r: 0.299; p:0.033).No correlation was found between LMR and radiographic score.Conclusion:Our study showed that the modified Sharp score correlated with PLR, NLR, FAR and CAR in patients with RA. This finding suggests that these ratios could be used as inexpensive and reliable markers to reflect radiographic joint damage.Longitudinal studies are necessary to confirm our results.References:[1]Syversen SW, Landewe R, Van Der Heijde D, Bathon JM, Boers M, Bykerk VP, et al. Testing of the OMERACT 8 draft validation criteria for a soluble biomarker reflecting structural damage in rheumatoid arthritis: a systematic literature search on 5 candidate biomarkers. J Rheumatol. 2009;36(8):1769-84.Disclosure of Interests:None declared

scholarly journals Novel Composite Radiographic Score for Longitudinal Observational Studies of Psoriatic Arthritis: A Proof-of-concept Study

2016 ◽  
Vol 43 (2) ◽  
pp. 367-370 ◽  
Author(s):  
William Tillett ◽  
Gavin Shaddick ◽  
Deepak Jadon ◽  
Graham Robinson ◽  
Eleanor Korendowych ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Observational Studies ◽  
Joint Space Narrowing ◽  
Joint Space ◽  
Proof Of Concept ◽  
X Ray ◽  
Radiographic Score ◽  
Hands And Feet ◽  
Longitudinal Observational Studies ◽  
Data Reductions

Objective.To devise a feasible composite radiographic score for use in observational studies of psoriatic arthritis (PsA).Methods.Radiographs from 50 patients with PsA were evaluated with the PsA-modified Sharp, Sharp/van der Heijde (SvdH), and Ratingen scores. Data reductions were made to devise a concise score.Results.The Reductive X-ray Score for Psoriatic Arthritis (ReXSPA) required the assessment of only 22 joints (234 points), including erosion, joint space narrowing, and osteoproliferation in the hands and feet. The ReXSPA accounted for 80% of change detected with the SvdH score.Conclusion.We report a proof-of-concept radiographic score for observational studies derived though data reduction.

scholarly journals FRI0043 JOINT SPACE NARROWING PRECEDES EROSIVE RADIOGRAPHIC DAMAGE IN PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 596.2-597
Author(s):  
A. Kerschbaumer ◽  
F. Alasti ◽  
G. Supp ◽  
J. S. Smolen ◽  
D. Aletaha
Keyword(s):  
Rheumatoid Arthritis ◽  
Joint Space Narrowing ◽  
Radiographic Progression ◽  
Cox Regression ◽  
Cartilage Damage ◽  
Joint Space ◽  
Time To Progression ◽  
Research Support ◽  
Radiographic Damage ◽  
Hands And Feet

Background:Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized through symmetric polyarthritis leading to joint destruction over time in many patients. Radiographic damage is an important outcome in RA clinical trials, most commonly assessed by conventional radiographs and quantified/reported by the modified total Sharp van der Heijde Score (mTSS). The mTSS is assessing erosive (ERO) changes as well as joint space narrowing (JSN; reflecting cartilage wasting) in the small joints of the hands and feet. While erosions are the hallmarks of RA, loss of cartilage has been reported to be highly relevant for functional limitations in RA. The sequence of occurrence of these events is not completely understood.Objectives:To investigate the time to radiographic progression and assess potential differences between time-to-JSN progression and time-to-ERO progression.Methods:Radiographs of RA patients from a large prospective clinical routine cohort were scored using the mTSS by one experienced reader (G.S.) unaware of the aim of this project. Time-to-JSN and time-to-ERO was estimated using survival analyses utilizing the Kaplan-Meier estimator. In additional analyses, patients were stratified based on JSN and/or ERO damage at baseline. Further, potential predictors (demographics, csDMARD/bDMARD treatment/combination therapy) of time-to-ERO and time-to-JSN were evaluated using Cox-regression techniques. All statistical analyses were conducted using SAS v9.4 (Cary, New York, USA).Results:We assessed 798 patients longitudinally for radiographic progression. JSN occurred significantly earlier than erosions (p<0.001, Figure 1). After stratification for baseline damage (Figure 2), these differences remained significant with a shorter time-to-JSN in patients without any baseline ERO or JSN (n=44, p=0.008), patients with JSN but no ERO at baseline (n=200, p<0.001), and patients with baseline ERO and JSN (n=536, p<0.001). Only in the small group of patients with isolated erosions (without JSN) at baseline there was no difference in time-to-progression of ERO vs. JSN (n=18, p=0.241). Overall, shorter time to progression of ERO was significantly predicted by positivity for rheumatoid factor or anti-citrullinated peptide antibodies (CCP; p<0.003), as well as by erosions at baseline (p<0.001) in Cox regression. In contrast, seropositivity for neither RF nor CCP was associated with shorter time to JSN progression (p=0.226); however, baseline concomitant JSN and ERO damage did show to be a significant predictor (p<0.001).Figure 1.Time to joint space narrowing and time to erosive damage (n=798).Figure 2.Time to JSN/ERO stratified by presence or absence of ERO/JSN at baseline.Conclusion:We identified a significantly shorter time to progression of JSN compared to ERO in this longitudinal cohort of RA patients. JSN remains an important radiographic outcome, as it is strongly associated with impairment of physical function. This calls for a stronger focus on cartilage damage in RA, and a stronger consideration of JSN in routine evaluation of RA radiographs in clinical practice.Disclosure of Interests:Andreas Kerschbaumer Paid instructor for: Celgene, Speakers bureau: Andreas Kerschbaumer has received lecture fees from Bristol-Myers Squibb, Gilead, Merck Sharp and Dohme and Pfizer., Farideh Alasti: None declared, Gabriela Supp: None declared, Josef S. Smolen Grant/research support from: AbbVie, Eli Lilly, Janssen, Merck Sharp & Dohme, Pfizer, Roche – grant/research support, Consultant of: AbbVie, Amgen Inc., AstraZeneca, Astro, Celgene Corporation, Celtrion, Eli Lilly, Glaxo, ILTOO, Janssen, Medimmune, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Samsung, Sanofi, UCB – consultant, Speakers bureau: AbbVie, Amgen Inc., AstraZeneca, Astro, Celgene Corporation, Celtrion, Eli Lilly, Glaxo, ILTOO, Janssen, Medimmune, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Samsung, Sanofi, UCB – speaker, Daniel Aletaha Grant/research support from: AbbVie, Novartis, Roche, Consultant of: AbbVie, Amgen, Celgene, Lilly, Medac, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi Genzyme, Speakers bureau: AbbVie, Celgene, Lilly, Merck, Novartis, Pfizer, Sanofi Genzyme, UCB

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