Onset, Early Stages, and Prognosis of Rheumatoid Arthritis: A Clinical Study of 100 Patients with 11-year Follow-up

TLDR

A prospective cohort of 100 patients with definite or classical rheumatoid arthritis was followed from within one year of disease onset to 8–14 years later in a hospital clinic. Patients were followed from within one year of RA onset to 8–14 years later, during which the mean delay to first clinic visit was 3.7 months, onset peaked in winter, 23 had prodromal symptoms, 14 had possible precipitating factors, and 88 % had a positive rheumatoid factor at some point; over the follow‑up 17 died (five likely disease‑related), the remaining showed improved ESR, hemoglobin, RF titre and disease status but a decline in functional capacity, and early RF titre and functional capacity were predictive of long‑term outcome while other factors were not.

Abstract

One hundred patients with "definite" or "classical" rheumatoid arthritis were followed in a hospital clinic from within one year of the onset of the arthritis. The average interval between onset and first attendance was 3·7 months. Onset was commoner in the winter, transient prodromal symptoms being noted in 23, with possible precipitating factors in 14. The serum rheumatoid factor test was positive at some time in 88. The patients were reassessed between eight and 14 years later. Seventeen died during this period, five possibly as a result of the disease or its treatment. The remaining patients had improved as a whole in terms of the blood sedimentation rate, haemoglobin, titre of the rheumatoid factor test, and status of the disease, but there was an overall deterioration in functional capacity. Both the rheumatoid factor titre and the functional capacity at an earlier review could be directly correlated with the outcome, but other factors were not found to influence the ultimate prognosis.