This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. We are proposing to establish the Early Rheumatoid Arthritis (ERA) patient registry and DNA repository as a means of promoting the planned and ongoing research of UAB investigators. The ERA registry will complement the NIH funded Consortium for the Longitudinal Evaluation of African-Americans with Early Rheumatoid Arthritis (CLEAR) and allow for direct comparisons of RA outcomes (and determinants of outcomes) across ethnic/racial groups. Data collected in this pilot project, along with data from the CLEAR cohort, will be used to test the following hypotheses: 1) Compared to African-American patients, Caucasian RA patients will more often have joint erosions detected on hand or foot radiographs at 5 years of disease duration; 2) A positive HLA-DR4 status will be predictive of disease severity (as evidenced by radiographic erosions at 5 years of disease duration) in Caucasians but not in African-Americans, and; 3) A general model that incorporates genetic and environmental factors can be developed to provide clinicians reliable information expected rapidity of progression of joint erosion for individual patients on the basis of data available at the baseline visit. These cohort-based comparisons have significant potential in defining important prognostic indicators in RA and thus, have major therapeutic implications. Requested GCRC funds will offset the initial radiographic costs during the first two years of establishing the ERA
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