Partial bone erosion repair is independently associated with functional improvement in early rheumatoid arthritis: a 2-year prospective high-resolution peripheral quantitative CT (HR-pQCT) longitudinal study
In brief
One in six with early rheumatoid arthritis had erosion repair tied to better function
In a 2-year study of 101 people receiving tight-control treatment, 16% had partial repair of bone erosions on high-resolution scans. Among them, greater erosion-volume reduction tracked with improved function even after accounting for disease activity, while erosions progressed in 39%; the observational findings show an association, not that repair caused functional gains.
- Journal
- RMD open (Q1)
- Published
- 28 September 2026
- Study design
- Cohort / observational study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Qihan Wu, Sze-Lok Lau, Isaac T Cheng, Tin Yuet Chan, James Griffith, Yan Kitty Kwok, et al.
- PMID
- 42805636
- DOI
- 10.1136/rmdopen-2026-007195
Why clinicians should know about it
- Picked for Rheumatology (paper of the day, 4 October 2026): Partial bone erosion repair linked to functional improvement in early
Abstract
OBJECTIVE: To determine whether change in bone erosion volume detected by high-resolution peripheral quantitative CT (HR-pQCT) is independently associated with functional outcome in early rheumatoid arthritis (ERA). METHODS: In this prospective study, 101 patients with ERA received 2-year tight-control treatment aiming at Simplified Disease Activity Index (SDAI) remission (SDAI ≤3.3). HR-pQCT of the second to fourth metacarpophalangeal joints was performed at baseline and at month 24 to quantify erosion parameters. Partial erosion repair was defined as a reduction of at least one erosion count or a decrease in total erosion volume exceeding the least significant change; progression was defined conversely. Functional status was assessed using the Health Assessment Questionnaire-Disability Index (HAQ-DI). RESULTS: After 2 years, disease activity and HAQ-DI improved significantly (all p<0.001) in paired analyses (n=98). Sixteen (16.3%) patients showed partial erosion repair and 38 (38.8%) erosion progression. In the partial erosion repair group, reduction in total erosion volume correlated strongly with HAQ-DI improvement (ρ=0.719, p=0.003). This association remained significant in linear regression analyses (β=0.607, p=0.003) independent of the contribution from change in SDAI (β=0.453, p=0.018). By contrast, among erosion progressors, change in HAQ-DI was primarily driven by improvement in SDAI (β=0.755, p<0.001). Baseline swollen joint count was associated with erosion progression in univariate analysis (OR 1.177, 95% CI 1.026 to 1.349, p=0.020) and after adjustment for sex (OR 1.171, 95% CI 1.019 to 1.346, p=0.026). CONCLUSION: HR-pQCT-detected partial repair of bone erosion was independently associated with functional improvement beyond inflammation control.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.