Prognosis for patients with rheumatoid arthritis
Note: The prognosis is very good for most people with RA who are referred and treated early.
The prognosis is very good for most people with rheumatoid arthritis (RA) who are referred to a specialist and treated early with disease-modifying antirheumatic drugs (DMARDs).
Key indicators of a poor prognosis for patients with RA are listed in Key indicators of a poor prognosis for people with rheumatoid arthritis. No single feature is entirely reliable in determining prognosis. When someone with RA has indicators of a poor prognosis, treatment should be more intensive and started as early as possible.
Note: When someone with RA has indicators of a poor prognosis, treatment should be more intensive and started as early as possible.
Key indicators of a poor prognosis for people with rheumatoid arthritis include:
- persistent disease activity despite DMARD therapy
- bony erosions evident on X-ray early in disease
- sustained raised inflammatory markers (ESR or serum CRP concentration)
- swelling in more than 20 joints
- impaired joint function early in disease
- a high RF titre or a positive anti-CCP antibody test
- failure of at least 2 DMARDs.
Note: CCP = cyclic citrullinated peptide; CRP = C-reactive protein; DMARD = disease-modifying antirheumatic drug; ESR = erythrocyte sedimentation rate; RF = rheumatoid factor