Table 3

Articles reporting clinical features alone, or as part of a risk prediction tool, as risk factors in individuals at risk of RA

StudyPopulationCohort sizeRisk factorFrequencyPart of composite risk prediction tool?Outcome
MSK symptoms without arthritis
van de Stadt et al14Seropositive arthralgia (ACPA and/or RF)374Symptoms duration <12M
Intermittent symptoms
Symptoms in upper and lower extremities
VAS pain ≥50
EMS >60 min
Swollen joints reported
BLYDevelopment of IA
Symptoms duration <12M: HR=1.72 (95% CI 1.39 to 2.15)
Intermittent symptoms: HR=1.75 (95% CI 1.41 to 2.16)
Symptoms upper and lower extremities: HR=1.37 (95% CI 1.12 to 1.68)
VAS pain ≥50: HR=2.29 (95% CI 1.85 to 2.85)
EMS >60 min: HR=1.67 (95% CI 1.29 to 2.15)
Swollen joints reported: HR=1.78 (95% CI 1.46 to 2.20)
Rakieh et al15Anti-CCP+ individuals with non-specific MSK symptoms100EMS ≥30 minBLYDevelopment of IA
HR=1.85 (95% CI 1.02 to 3.35), p=0.043
Burgers et al22CSA354 (2 cohorts)Positive definition of CSA (EULAR definition for suspicious arthralgia) ≥3 parameters presentBLYDevelopment of IA
HR=2.1 (95% CI 0.9 to 4.7)
Nakajima et al61ACPA+ individuals without clinical synovitis18Tenderness of DAS-28 subject joints at the first visitBLNDevelopment of IA
Progressors versus non-progressors:
tenderness present in 10/10 patients vs 2/8 patients (p=0.0044)
Early clinical arthritis
Gonzalez-Lopez et al31PR—Gonzalez Lopez criteria127Frequency of PR attacksBLYDevelopment of a chronic connective tissue disease
HR 1.03 (95% CI 1.01 to 1.05), p=0.03
El Miedany et al24UA—synovitis >2 joints for ≤6 months173EMS durationBLYDevelopment of persistent arthritis
OR 1.15 (95% CI 1.094 to 1.222), p<0.001
Kuriya et al29UA—symptoms ≤12 months105TJC
SJC
HAQ score
BLYDevelopment of RA
Progressors versus non-progressors:
TJC (median 22 vs 4), p<0.001
SJC (median 12 vs 1), p<0.001
HAQ score (mean 0.94 vs 0.52), p=0.006
Salaffi et al62UA—symptoms ≤16 weeks149Symptoms ≥6 weeks
EMS >30 min
BLYDevelopment of RA
Symptoms ≥6 weeks: OR=4.97 (95% CI 1.39 to 17.88), p=0.014
EMS >30 min: OR=3.16 (95% CI 1.06 to 9.46), p=0.039
Tamai et al32PR—Gonzalez Lopez criteria28PIP joint involvementBLNDevelopment of RA
HR 27.16 (95% CI 1.55 to 474.22), p=0.024
Ha et al27UA—(not meeting 1987 RA criteria)164EMS >30 min
SJC ≥4
BLYDevelopment of RA
EMS >30 min: OR=11.9 (95% CI 2.0 to 71.7), p=0.007
SJC ≥4: OR=13.8 (95% CI 1.7 to 112.4), p=0.014
Bizzaro et al26UA—symptoms ≤12 weeks192Hand joint arthritisBLYDevelopment of RA
HR=2.140 (95% CI 1.128 to 4.059) p=0.02
McNally et al25UA—up to 12M symptoms, synovitis in ≥1 joint1084Score of ≥8 on the Leiden Clinical Prediction RuleMeta-analysisYDevelopment of RA at 1 year
Specificity 95% (95% CI 92 to 97) and sensitivity 49% (95% CI 43 to 55)
Yiannopoulos et al30UA192Disease durationBLNDevelopment of RA
Progressors versus non-progressors
Disease duration 28.5 months vs 45.3 months, p=0.018
  • HR/OR and CIs have been reported where available.

  • +, positive; A, abstract only; ACPA, anticyclic citrullinated peptide; BL, baseline; CCP, cyclic citrullinated peptide; CPR, clinical prediction rule; CRP, C reactive protein; CSA, clinically suspect arthralgia; DAS-28, Disease Activity Score-28 joints; EMS, early morning stiffness; ESR, erythrocyte sedimentation rate; FDRs, first-degree relatives; HAQ, Health Assessment Questionnaire; IA, inflammatory arthritis; M, months; MSK, musculoskeletal; PD, power Doppler; PIPs, proximal interphalangeal joints; PPV, positive predictive value; PR, palindromic rheumatism; RA, rheumatoid arthritis; RADAI, rheumatoid arthritis disease activity index; RF, rheumatoid factor; STJ, swollen joints count; TJC, tender joints count; UA, undifferentiated arthritis; US, ultrasound; VAS, visual analogue scale.