Significance of Our Work for RA
Structural damage, assessed on plain films, can indeed be used as a surrogate for clinical outcome.
RA affects 0.5–1% of the global population and is associated with disability, work loss, and premature death. In the USA, this equates to a cost of $19.3 billion annually in both healthcare and indirect expenses.
There is more and more evidence available from clinical trials and cohort studies of a clear relation between inflammation (disease activity) and structural damage, as well as a relation between structural damage and clinical outcome.
There is a relation between the response to treatment when measured as clinical disease activity and when measured as radiographic progression in most clinical therapeutic trials. This is robust evidence for the hypothesis that inflammation leads to structural damage.