A matrix has been developed to predict which patients with early rheumatoid arthritis will have rapid radiographic progression (RRP) despite treatment with DMARDs. On the basis of data from 370 patients, 11.1% of whom had RRP (defined by change in van der Heijde-modified Sharp score) after 1 year, key baseline predictors of RRP are swollen joint count, C-reactive protein level, and the presence of anticitrullinated protein antibodies and radiographic erosions.