The outcome of rheumatoid arthritis (RA) should be determined early. Rapid radiological
progression (RRP) is > or = 5 units increase according to the van der Heijde-Sharp
score within a year. The risk of RRP can be estimated by a matrix model using non-radiographic
indicators, such as C-reactive protein (CRP), rheumatoid factor (RF) and swollen joint
count (SJC).A non-interventional, cross-sectional, retrospective study was conducted
in eleven Hungarian arthritis centres. We assessed RRP risk in biologic-naïve RA patients
with the prevalence of high RRP risk as primary endpoint. RRP was calculated according
to this matrix model. As a secondary endpoint, we compared RRP in methotrexate (MTX)
responders vs non-responders.We analyzed data from 1356 patients. Mean CRP was 17.7
mg/l, RF was 139.3 IU/ml, mean 28-joint disease activity score (DAS28) was 5.00 and
mean SJC was 6.56. Altogether 18.2% of patients had high risk (≥40%) of RRP. RA patients
with high RRP risk of RRP (n = 247) had significantly lower age compared to those
with RRP < 40% (n = 1109). MTX non-response (OR: 16.84), male gender (OR: 1.67), erosions
at baseline (OR: 1.50) and ACPA seropositivity (OR: 2.18) were independent predictors
of high-risk RRP. Male gender (OR: 5.20), ACPA seropositivity (OR: 4.67) and erosions
(OR: 7.98) were independent predictors of high RRP risk in MTX responders.In this
Hungarian study, high RRP risk occurred in 18% of RA patients. These patients differ
from others in various parameters. RRP was associated with non-response to MTX.
