{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T14:54:23Z","timestamp":1774882463911,"version":"3.50.1"},"reference-count":17,"publisher":"The Journal of Rheumatology","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>To assess whether early swelling and tenderness in large joints in patients with rheumatoid arthritis (RA) is predictive of later local damage and whether this leads to functional disability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>Two-year clinical and 8-year radiological followup data from the BeSt study (trial numbers NTR262 and NTR265), a randomized controlled treat-to-target trial, were used. The association between early local joint swelling and\/or tenderness (at least once, or for \u2265 2 consecutive visits) and later large-joint damage (Larsen score \u2265 1) was assessed using generalized estimating equations. The association between large-joint damage and functional ability [by Health Assessment Questionnaire (HAQ)] was assessed using logistic and linear regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Clinical and 8-year radiological data were available for 290 patients. Concomitant local joint swelling and tenderness at least once in the first 2 years was independently associated with damage of the large joints (OR 2.5, 95% CI 1.7\u20133.6), as was swelling without tenderness (OR 2.0, 95% CI 1.1\u20133.6). Stronger effects were seen for persistent swelling and\/or tenderness. Other independent predictors for joint damage were baseline erythrocyte sedimentation rate (OR 1.01, 95% CI 1.01\u20131.02) and the presence of rheumatoid factor and\/or anticitrullinated protein antibodies (OR 2.5, 95% CI 1.5\u20134.1; and OR 2.2, 95% CI 1.3\u20133.8, respectively). Patients with large-joint damage had a higher HAQ score after 8 years than patients without (difference 0.15).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>Early local swelling and tenderness are independent predictors of later joint damage in these joints after 8 years of Disease Activity Score-guided treatment in patients with RA. This suggests that suppression of local inflammation could help prevent local damage and functional disability.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.121248","type":"journal-article","created":{"date-parts":[[2013,4,2]],"date-time":"2013-04-02T00:59:34Z","timestamp":1364864374000},"page":"624-629","source":"Crossref","is-referenced-by-count":17,"title":["Early Local Swelling and Tenderness Are Associated with Large-joint Damage After 8 Years of Treatment to Target in Patients with Recent-onset Rheumatoid Arthritis"],"prefix":"10.3899","volume":"40","author":[{"given":"Marianne","family":"van den Broek","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Dirven","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herman M.","family":"Kroon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margreet","family":"Kloppenburg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. 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