Mucosal healing predicts the long-term prognosis of intestinal Behcet’s disease. Previously, the identified independent risk factors for poor prognosis in intestinal ABD were male gender, mucosal healing, volcano-shaped ulcers, larger size of intestinal ulcers (> 2 cm) and elevated CRP levels (≥ 44 mg/L )[10, 20–22]. Clinical, functional, and radiographic implications of time to treatment response in patients with early rheumatoid arthritis: a posthoc analysis of the PREMIER study. 2016;43:1974–83. Arthritis Rheum. Extraarticular disease appears as a poor prognostic feature in the ACR recommendations only. All factors with P-values less than 0.20 were assessed using a multiple Cox model. These matrices provide estimates of the probability of having rapid radiologic progression at one year if one predictor or a combination of predictors are present. A number of prognostic factors related to patient and tumor characteristics have been described for AML, including age, performance status, and karyotype . Bone edema scored on magnetic resonance imaging scans of the dominant carpus at presentation predicts radiographic joint damage of the hands and feet six years later in patients with rheumatoid arthritis. Endoscopic findings of gastrointestinal involvement in Chinese patients with Behcet's disease. Cheon JH, Han DS, Park JY, Ye BD, Jung SA, Hong SP, Park YS, et al. Perspectives on future research are also outlined. Purpose: To identify prognostic factors for poor visual outcome in patients with birdshot retinochoroidopathy. Analyses from the PREMIER and TEMPO trials already demonstrated that early treatment response predicted low disease activity [17, 18]. Arthritis Research & Therapy Smoking is known to be associated with the development of RA and with treatment response [14] but the impact on clinical or radiologic outcomes has not been clarified. Second, we were not able to evaluate the complications, because the complication rate was too low to be calculated. Ng WL, Adeeb F, Sebastian A, Anjum A, Brady M, Gillespie M, et al. In the ACR recommendations, references are given for autoantibody positivity and erosions only. The use of poor prognostic factors varies among recommendations, clinical trials, and cohort studies. The number (≥ 3) and size (> 1 cm) of intestinal ulcers were found in 62 patients (56.88%) and 33 patients (30.28%), respectively. Other factors not strongly predictive of outcome include: age, sex, cause of arrest, type of arrhythmia, total arrest time, duration of CPR, geographic location of arrest, elevated body temperature, elevated intracranial pressure, concurrent respiratory failure, and early brain imaging findings (3,6,7,8). Intestinal involvement occurs in 10–20% of patients [7]. The aim of this study was to investigate factors associated with survival outcome in anaplastic oligodendroglioma patients. We prospectively enrolled all followed-up patients who had been treated in the Department of RHEUMATOLOGY and Immunology of Huadong Hospital affiliated with Fudan University, Shanghai, China between October 2012 and January 2019. Secondly, Markusse et al. The intestinal symptoms and size of intestinal ulcers (> 1 cm) were similar among the 3 groups, but the number of intestinal ulcers (≥ 3) was more frequent in group with both ileocecal and colorectum ulcers (P = 0.000). Expression of a soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) correlates with clinical disease activity in intestinal Behcet’s disease. Zouboulis CC. Magnetic resonance imaging findings in 84 patients with early rheumatoid arthritis: bone marrow oedema predicts erosive progression. 2003;48:1814–27. Fautrel B, Granger B, Combe B, et al. Prognosis is often determined after initial treatment assuming favourable outcome. CAS  Privacy In a risk model from the SWEFOT cohort, current smoking was reported to be a strong independent predictor of radiographic progression [15]. Should seronegative RA be treated differently? Analyses were performed using SPSS 22.0. CAS  Matrix to predict rapid radiographic progression of early rheumatoid arthritis patients from the community treated with methotrexate or leflunomide: results from the ESPOIR cohort. 2016;55:89–93. Received 2019 Jul 7; Accepted 2019 Oct 21. In multivariate analysis, location of intestinal ulcers (ileocecal and colorectum) (OR 7.100 [95% CI 1.810–27.855]), ESR > 24 mm/h (OR 5.966 [95% CI 1.734–20.528]), IFX therapy (OR 0.175 [95% CI 0.036–0.852]), and poor compliance (OR 8.557 [95% CI 1.914–38.255]) were independently correlated with a poor outcome. This was a prospective cohort study of 109 intestinal ABD patients seen in our institution between October 2012 and January 2019 who met the international criteria for ABD and had intestinal ulcers confirmed on colonoscopy. To identify the predictive factors associated with worse prognosis in the Guillain-Barré syndrome (GBS), which can be helpful to fully evaluate the disease progression and provide proper treatments. This review summarizes the current definitions of poor prognostic factors and their use in clinical research. Children with Ewing sarcoma that has only spread to a lung have a more favourable prognosis than those with metastasis to other parts of the body. Adamantiades-Behçet’s disease, Intestinal ulcers, Prognostic factors, Recurrence. Performance of matrix-based risk models for rapid radiographic progression in a cohort of patients with established rheumatoid arthritis. Singh JA, Furst DE, Bharat A, et al. 2011;29(3 Suppl 66):S7–14. Arthritis Rheum. This discrepancy may be explained by the fact that the previous study defined long-term clinical outcomes as readmission and cumulative frequencies of surgical operation, both of which were differ from the supposed poor outcomes (non-healing ulcers) defined in our study. Zou J, Ji DN, Cai JF, Guan JL, Bao ZJ. Doctors use these gene mutations as prognostic factors for people with AML. Article  PLoS One. Clin Exp Rheumatol. Factors associated with poor outcome of intestinal ABD (non-healing intestinal ulcers) were subjected to univariate analysis using Wilcoxon’s test and χ2/Fisher’s exact tests for quantitative and categorical variables, respectively. Overall, 340 elderly patients with COVID-19 were enrolled in 3 hospitals in Daegu, South Korea. In the ESPOIR cohort, smoking was not predictive of rapid radiologic progression [10]. With this assessment, 46% of the cohort were assessed as having a poor prognosis. Some authors found that early-onset intestinal ABD patients presented with more severe clinical symptoms and poorer clinical outcomes because of stronger immune responses and higher frequency of volcano-shaped ulcers, also significantly associated with recurrences and poor prognosis in intestinal ABD [18, 34]. Ferraccioli G, Tolusso B, Fedele AL, Gremese E. Do we need to apply a T2T strategy even in ACPA-negative early rheumatoid arthritis? Smolen JS, Landewé R, Breedveld FC, et al. Future research questions should focus on the following points: The definition of poor prognostic markers depends on the targeted outcome, the methods of measurement, and the cut-off values. All 109 patients fulfilled the criteria of International Study Group for ABD [4]. Other factors that have been investigated include disability at baseline, extraarticular disease, smoking, imaging markers, protein biomarkers, and genetic markers. IFX is the first-line therapy for moderate-to-severe intestinal ABD. A total of 30.27% of the patients showed poor compliance with treatment regimens. IFX was thought to alter the natural course of intestinal ABD. Iwata S, Saito K, Yamaoka K, Tsujimura S, Nawata M, Suzuki K, et al. Therefore, novel mechanistic biomarkers that are directly involved in the disease pathogenesis are being increasingly investigated [19]. The purpose of this study was to identify a gene expression profile associated with CRC that may contribute to the early diagnosis of CRC and improve patient prognosis. Disease activity has been assessed by serum levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) as well as the number of tender joints (TJC) and swollen joints (SJC). The ePub format is best viewed in the iBooks reader. The incorporation of novel potential prognostic factors into risk models is requested by van der Helm-van Mil [1]. Genetic predisposition of the severity of joint destruction in rheumatoid arthritis: a population-based study. Krause I, Weinberger A. Behcet’s disease. This was a multicenter and retrospective study. 2013;65:1985–94. These prediction models are matrix models and all consist of at least two matrices to consider the different treatment strategies in the original trials they are derived from. Various risk matrices have been developed to identify patients at risk for rapid radiologic progression [7, 9, 15, 32]. Granger B, Combe B, Le Loet X, Saraux A, Guillemin F, Fautrel B. All authors read and approved the final manuscript. De Punder et al. The progression of erosion and joint space narrowing scores in rheumatoid arthritis during the first twenty-five years of disease. Methods: A case-control study of 98 patients with birdshot retinochoroidopathy (196 eyes) was evaluated with a follow-up period of at least 12 months. The importance of extraarticular RA features is that they reflect severe disease, more often seen in past and longstanding disease. Some reports revealed that excellent compliance was the most remarkable patient-related factor for treatment success [25]. Clinical efficacy and safety of abatacept in methotrexate-naive patients with early rheumatoid arthritis and poor prognostic factors. 2016;2(1):e000263. The principle symptoms of ABD (oral ulceration, genital ulcer, skin lesions, uveitis, and neurological involvement) were similar in the 3 groups. Performance of matrices developed to identify patients with early rheumatoid arthritis with rapid radiographic progression despite methotrexate therapy: an external validation study based on the ESPOIR cohort data. 2014;16:430. You may notice problems with In a study of patients with Crohn’s disease, those with elevated ESR (> 15 mm/h) levels had an 8-fold greater rate of flare-ups [29]. Ann Rheum Dis. already built in. High proportions of poor compliance in rheumatic diseases varied from 20 to 90%, directly or indirectly leading to severe consequences [15, 16]. Two factors remained significantly associated with the risk for poor prognosis in subjects with severe meningitis, unequal pupil size in both eyes (regression coefficient 1.662, OR 5.268) and CSF glucose content <1.5 mmol/L (regression coefficient 1.500, OR 4.483). Saevarsdottir S, Wallin H, Seddighzadeh M, et al. The 2nd edition of consensus statements for the diagnosis and management of intestinal Behcet’s disease: indication of anti- TNFα monoclonal antibodies. Patients who already show evidence of negative symptoms and poor function have a poor prognosis as negative symptoms are a cause of great disability and usually get worse with time. Some of the factors that affect prognosis include: The type of cancer and where it is in your body; The stage of the cancer, which refers to the size of the cancer and if it has spread to other parts of your body; The cancer’s grade, which refers to how abnormal the cancer cells look under a microscope. Google Scholar. Poor prognostic factors guiding treatment decisions in rheumatoid arthritis patients: a review of data from randomized clinical trials and cohort studies. Haavardsholm EA, Bøyesen P, Østergaard M, et al. Prognostic factors are used for RA diagnosis, treatment decisions, and prognosis of disease severity. http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, Age at the diagnosis of BS, median (IQR) years. Factors correlated with relapses or non-healing intestinal ulcers were subjected to univariate analysis using the log rank test and were expressed as hazard ratio (HR) and 95% confidence interval (95% CI). However, of the 54% without poor prognosis, more than 60% had erosive disease and more than 40% were either ACPA- or RF-positive. We also observed that ESR > 24 mm/h and IFX therapy were independently predictive of non-healing intestinal ulcers for intestinal ABD. http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, https://doi.org/10.1186/s13075-017-1266-4. The presence of erosions at baseline has been reported by qualitative measure (yes/no) [7] or by the evaluation of radiographs using the Sharp score [9]. YES RMD Open. Using a COX proportional hazards model, the factors that had negative impact on event-free survival were WBC > 6.4 × 109/L (HR 1.767 [95% CI 0.940–3.323]), Hb < 123 g/L (HR 1.552 [95% CI 0.826–2.916]), ESR > 24 mm/h (HR 2.176 [95% CI 1.107–4.276]), and poor compliance (HR 3.258 [95% CI 1.733–6.126]), but male sex (HR 0.571 [95% CI 0.299–1.092]), early onset of ABD (< 7 years) (HR 0.444 [95% CI 0.231–3.323]), and Biologics (HR 0.369 [95% CI 0.192–0.710]), IFX therapy (HR 0.461 [95% CI 0.224–0.948]) were associated with longer event-free survival by univariate analysis (Table ​(Table44). Medicine (Baltimore). Validation of a novel multibiomarker test to assess rheumatoid arthritis disease activity. They should be kept in mind even though no validation studies have referenced extraarticular disease as a prognostic factor [4]. Poor prognosis was, firstly, defined as the presence of at least three out of four poor prognostic factors: DAS ≥3.7, SJC ≥10, erosions ≥4, and both RF- and ACPA-positive. At the same level of inflammation, ACPA-negative patients have less joint damage and a lower probability of damage in newly affected joints than ACPA-positive patients. The prognosis is guarded. Google Scholar. Google Scholar. These features are still under investigation or do not appear uniformly in recommendations and clinical research. But it is not evident whether this also applies for remission and functional preservation. Poor outcome of intestinal ABD was defined as repeated colonoscopy showing intestinal ulcers after standard treatment modification or intensification. The intestinal ulcers of intestinal ABD are mostly located in the terminal ileum and the cecum, and the most common intestinal symptom is abdominal pain, ranging from mild to severe, with or without fever, diarrhea, hematochezia, or weight loss [5, 8, 9]. Predictors of response to methotrexate in early DMARD naive rheumatoid arthritis: results from the initial open-label phase of the SWEFOT trial. Bykerk VP, Akhavan P, Hazlewood GS, et al. Google Scholar. The datasets used and analyzed during the current study are available from the corresponding author on reasonable request. With this assessment, 46% of the cohort were assessed as having a poor prognosis. Other standard definitions of remission according to the Clinical Disease Activity Index (CDAI), the Simplified Disease Activity Index (SDAI), or the Routine Assessment of Patient Index Data (RAPID-3) are also considered in the ACR recommendations [4]. Besides autoantibody positivity and erosions, functional limitation and extraarticular disease are also considered as poor prognostic features [4]. Ann Rheum Dis. Subtypes M0 through M5 all start in immature forms of white blood cells. Appropriate assessment of prognostic factors and close monitoring to provide the necess … Various biomarkers have already been established as prognostic factors. The predictive factors of non-healing ulcers that had P-values of < 0.20 in univariate analysis were included in a multiple logistic regression model. According to Recommendation 8, the change to another csDMARD strategy should be considered in the absence of poor prognostic factors, and addition of a bDMARD should be considered when poor prognostic factors are present [3]. Liang Zhang, Yun Tian, [...], and Jian-Long Guan. The importance of single or combined presence is not assessed. Patients are then categorized based on presence or absence of one or more of the following poor prognostic features: functional limitation (e.g., HAQ score or similar valid tools); extra-articular disease (e.g., presence of rheumatoid nodules, RA vasculitis, Felty’s syndrome); RF or ACPA antibodies; bony erosions on radiographs. A genetic predisposition not only for the development of RA but also for disease severity is indicated by a population-based study of Knevel et al. Prognostic factors toward clinically relevant radiographic progression in patients with rheumatoid arthritis in clinical practice: a Japanese multicenter, prospective longitudinal cohort study for achieving a treat-to-target strategy. 37, 39 In patients with an acute spondylolysis, these factors were not related to a poor clinical outcome. An event was defined as the appearance of relapse of intestinal ABD or non-healing intestinal ulcers during a follow-up period. Ann Rheum Dis. Evaluation of prognosis related to compliance with supportive periodontal treatment in patients with chronic periodontitis: a clinical retrospective study. We are experimenting with display styles that make it easier to read articles in PMC. Relapses of intestinal ABD were defined as recurrences of intestinal ulcers on repeated enteroscopy after ulcer healing. 2012;8:312–3. Zayed HS, Medhat BM, Seif EM. Sanmartí R, García-Rodríguez S, Álvaro-Gracia JM, et al. Factors independently associated with shorter event-free survival were early onset of ABD (< 7 years) (hazard ratio (HR) 2.431 [95% CI 1.240–4.764]) and poor compliance (HR 3.058 [95% CI 1.612–5.800]). The median ESR level (39.00 mm/h [IQR 20.50–67.75]) was significantly higher in the intestinal ABD patients with both ileocecal and colorectum ulcers (P = 0.037). Gene mutations. Remission is mostly defined by the DAS28 using either DAS28-erythrocyte sedimentation rate (ESR) <2.6 [12, 16] or DAS-CRP <2.6 [29]. 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