Predicting Palindromic Prognosis Save
Dr. David Liew discusses abstract OP0127 at Eular 2024 in Vienna, Austria.
Transcription
Hi, David Lou here from Vienna, July 2024. Some of the highlights from rheumatoid arthritis today. Really interesting abstract from Leeds, from the powerhouse that is Leeds. And they looked at palindromic rheumatism, which is something that I think doesn't get talked about very much. But we do know that these patients certainly make our way in the door.
It's often hard to know exactly how to follow-up on them. Should we be seeing them frequently just in case they develop inflammatory arthritis? Should we just send them back to their primary care physician and just hope that all goes okay? Where do we sit in between? And it seems hard to be able to pick who is going to be able to be sent back to their primary care physician and who we have to watch closely.
So in Leeds, they've been looking at this for fifteen years. And they've got fifteen years of data that they've been able to compile into into a statistically into a point scoring system to help deal with this for you. So what they've done is they've in amongst that fifteen years of data, they've figured out relative weightings. I'll give you the point scoring system now. So female sex, two points.
Age over 40, one point. Smoking, ever, one point. Typical interval between attacks less than one month, one point. Anti CCP positive, up to three times the upper limit of normal, two points. Greater than three times upper limit normal, five points.
And then rheumatoid factor, positive one point. So that just breaks it out into strata, less than two, between two to eight, and greater than eight. And based on that, you can actually predict who's going to do what over time in their cohort. Obviously, it needs validation. But in that two or less, those people never develop inflammatory arthritis according to this cohort.
And then if you look at the moderate versus the high risk, that stratifies out quite nicely. If you look at it at one year, it stratifies out to be about ninety percent versus seventy percent in terms of developing not developing inflammatory arthritis. So that's, sorry, ten percent develop inflammatory arthritis versus thirty percent. And then if you go out to five years, we're looking at about a quarter developing inflammatory arthritis in the moderate risk group versus over half in the high risk group. So that really gives us an idea of if we can get we can stratify at the beginning, then we can really direct care.
And really that's the kind of thing that we would like to see more of. Like to see it validated as well, but this is a really great start. For plenty more about rheumatoid arthritis and everything else at your life twenty twenty four, you know where to go. Rheumnow.com.
It's often hard to know exactly how to follow-up on them. Should we be seeing them frequently just in case they develop inflammatory arthritis? Should we just send them back to their primary care physician and just hope that all goes okay? Where do we sit in between? And it seems hard to be able to pick who is going to be able to be sent back to their primary care physician and who we have to watch closely.
So in Leeds, they've been looking at this for fifteen years. And they've got fifteen years of data that they've been able to compile into into a statistically into a point scoring system to help deal with this for you. So what they've done is they've in amongst that fifteen years of data, they've figured out relative weightings. I'll give you the point scoring system now. So female sex, two points.
Age over 40, one point. Smoking, ever, one point. Typical interval between attacks less than one month, one point. Anti CCP positive, up to three times the upper limit of normal, two points. Greater than three times upper limit normal, five points.
And then rheumatoid factor, positive one point. So that just breaks it out into strata, less than two, between two to eight, and greater than eight. And based on that, you can actually predict who's going to do what over time in their cohort. Obviously, it needs validation. But in that two or less, those people never develop inflammatory arthritis according to this cohort.
And then if you look at the moderate versus the high risk, that stratifies out quite nicely. If you look at it at one year, it stratifies out to be about ninety percent versus seventy percent in terms of developing not developing inflammatory arthritis. So that's, sorry, ten percent develop inflammatory arthritis versus thirty percent. And then if you go out to five years, we're looking at about a quarter developing inflammatory arthritis in the moderate risk group versus over half in the high risk group. So that really gives us an idea of if we can get we can stratify at the beginning, then we can really direct care.
And really that's the kind of thing that we would like to see more of. Like to see it validated as well, but this is a really great start. For plenty more about rheumatoid arthritis and everything else at your life twenty twenty four, you know where to go. Rheumnow.com.
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