Table 2

Relationship between MDA status and measures of structural damage

Author (year)Study descriptionDefinition joint damage progressionAnalysis population/ subgroupsTime pointSubgroupMeasure
Cross-sectional studiesPresence of hand erosions
Queiro et al (2017)25Cross-sectional observational studyPresence of hand erosions by radiographic evidenceMDA (n=133)30.8%
Non-MDA (n=144)44.7%
P value<0.05
Longitudinal studiesPercentage of patients with no progression of joint damage or mean (SD) of joint damage score
Coates et al (2010)26Prospective longitudinal observational study to establish the frequency and predictors of MDAIf any joint changed from being non-damaged to damagedMDA at consecutive visits* ≥12 months (n=116)Mean follow-up 34 monthsMDA (n=116)69
Non-MDA (n=228)Non-MDA (n=200)51
P value<0.001†
Coates and Helliwell (2010)22Post hoc analysis of two RCTs to validate the MDA criteriaIncrease in modified SHS score of >0Phase II RCT (n=63)Week 50MDA (n=26)96
Non-MDA (n=37)67
P value0.012
Week 100MDA (n=12)100
Non-MDA (n=25)58
P value0.03
Phase III RCT (n=157)Week 54MDA (n=63)78
Non-MDA (n=94)57
P value0.009
Geijer et al (2015)27Prospective longitudinal observational study to evaluate the course of the disease and identify predictors of progressionWassenberg score256 week follow-upMDA (males‡, n=10)3.4 (3.99)
Non-MDA (males, n=19)10.94 (14.36)
P value0.042
Kavanaugh et al (2016)28Post hoc analysis of RCT, placebo to explore relationship of MDA to radiographic progressionIncrease in SHS score >0In MDA ≥3 consecutive visits over the course of the 256 week study (n=116)256 weeksMDA (n=41)35.3
Non-MDA (n=75)NR
P value0.054
In MDA ≥4 consecutive visits over the course of the 256 week study (n=95)256 weeksMDA (n=34)35.8
Non-MDA (n=61)23.2
P value0.056
  • *Patients evaluated every 6–12 months.

  • †P value represents comparison of mean change in joint damage over the study period in MDA versus non-MDA.

  • ‡Mean scores not reported for females; however, it was noted that the statistical comparison of joint damage for MDA versus non-MDA was not significant.

  • MDA, minimal disease activity; Non-MDA, patients not achieving MDA; NR, not reported; RCT, randomised controlled trial; SHS, Sharp/van der Heijde Score.