Table 1 Patient information and diagnostics summary
Time since onset of disease | 3 months | 1 year | 2 years | 5 years | 10 years | 11 years |
|---|---|---|---|---|---|---|
Clinical parameters | ||||||
DAS28 | 8.09 | 8.37 | 7.94 | 6.87 | 7.61 | 3.76 |
DAS28-CRP | 7.75 | 7.98 | 7.55 | 6.63 | 7.44 | 4.34 |
Bone erosions at X-rays | None | None | Yes | Yes | Yes | Yes |
Biological parameters | ||||||
ESR (mm, first hour; Nl < 20) | 63 | 68 | 37 | 8 | 24 | 5 |
CRP (mg/L; Nl < 10) | 56 | 85 | 25 | 1 | 18 | 7 |
Ferritin (μg/mL; Nl < 200) | 347 | 314 | 202 | 141 | 165 | Not evaluated |
Platelet count (Nl < 400 billion/L) | 469 | 390 | 348 | 225 | 247 | 263 |
RF | Undetectable | Undetectable | Undetectable | Undetectable | Undetectable | Undetectable |
Anti-CCP | Undetectable | Undetectable | Undetectable | Undetectable | Undetectable | Undetectable |
ANA | Undetectable | Undetectable | Undetectable | Undetectable | Undetectable | Undetectable |
Synovial fluid analysis | 8.93 billion WBC/L | 21.15 billion WBC/L | 120.8 billion WBC/L | |||
99% neutrophils | 99% neutrophils | 83% neutrophils | ||||
Diagnosis | Active early RA | Active early RA | Possible RA-like PsoA | RA-like PsoA with bone erosions | RA-like PsoA with bone erosions | RA-like PsoA with bone erosions |
Treatment prescribed | Prednisone Methotrexate Hydroxychloroquine Naproxen | Initial treatment + adalimumab (anti-TNF) | Stop adalimumab; Initial treatment + abatacept (IgG1 Fc-CTLA-4) | Initial treatment + abatacept (IgG1 Fc-CTLA-4) | Stop abatacept; Initial treatment + ustekinumab (anti-IL-12/IL-23) | Initial treatment + tocilizumab |
Notes | HLA-B27 absent Treatment at visit: diclofenac | Sterile synovial fluid was removed by joint aspiration | Sterile synovial fluid was removed by joint aspiration Mother and maternal grandmother have psoriasis An aunt and her son have inflammatory spondylarthritis | Appearance of psoriasis skin lesions Sterile synovial fluid was removed by joint aspiration Ustekinimab (anti-IL-12/IL-23) and secukinimab (anti-IL-17) were not authorized at the time | No improvement after 6 months treatment with ustekinumab Stop ustekinumab Enrollement in study to quantify cytokines in plasma and secreted by activated PBMCs Tocilizumab (anti-IL-6) begun | |