Long Term Prognosis of relapsing polychondritis in Daily Practice

Abstract

An abnormal cellular immune response against cartilage proteoglycans and the imbalance of T-cell subsets are considered among the primary factors in the pathogenesis of relapsing polychondritis. In these patients, there is substantial deposition of circulating antibodies and immune complexes in the joints, which are primarily directed toward the destruction of type II, IX, and XI collagen. HLA class II molecules have a direct association with relapsing polychondritis, and specifically, an increased presence of HLA-DR4 antigen is correlated with a higher risk of developing the disease. Based on these findings, the aim of this study was to evaluate the long-term prognosis of relapsing polychondritis in affected patients. Methods: This study is a cohort study involving patients with autoimmune disease. The study population consists of 29 patients diagnosed with relapsing polychondritis who visited rheumatology clinics in cities including Tabriz, Urmia, Tehran, Kashan, Mashhad, and Isfahan. The diagnosis was confirmed by a rheumatologist, and patients received treatment accordingly. Given the rarity of the disease, complete enumeration sampling was employed. Follow-up assessments included responses to initial treatment, long-term remission rates, drug-free remission, and the extent of damage caused by recurrent relapsing polychondritis. Results: The results of the study demonstrate that medications can significantly aid in the improvement of many patients; however, a notable proportion of patients experienced drug-free remission. Additionally, due to the recurrence of the disease following the discontinuation of DMARDs (Disease-Modifying Antirheumatic Drugs), current treatments may not provide permanent or definitive outcomes and instead require ongoing therapeutic approaches. A comparison of drug-free remission duration versus overall remission time indicates that some patients may achieve long-term recovery without the need for continuous medication.