Do any markers help predict if an Rheumatoid Arthritis patient will have severe disease and a poor prognosis?
Long disease duration prior to treatment, RF and ACPA positivity, and poor functional status (health assessment questionnaire score >1) at presentation are the best predictors of subsequent disability and joint damage. Other factors include:
• Generalized polyarthritis involving both small and large joints (>13 total joints)
• Extraarticular disease, especially nodules and vasculitis
• Persistently elevated ESR or CRP
• ANA positivity (if also RF-positive)
• Radiographic erosions within 2 years of disease onset
• HLA-DR4 genetic marker
• Low education level.