Comparison of physical function in early rheumatoid arthritis patients treated with biologics for 1year who achieved clinical remission or low disease activity.

Abstract

This study aimed to evaluate whether targeting clinical remission is appropriate for suppressing physical dysfunction in patients with early rheumatoid arthritis (RA). Subjects were all 75 early RA patients (within 2years of onset) who were continuously treated with biologics for 12months at our hospital. We evaluated the Simplified Disease Activity Index (SDAI) and Disability Index of the Health Assessment Questionnaire (HAQ-DI) at 3, 6, and 12months from the initiation of biologics therapy. Rates of functional remission (HAQ-DI≤0.5) at 12months in the clinical remission (SDAI≤3.3) group and the low disease activity [LDA (3.3<SDAI≤11)] group were 97 and 86%, respectively. Multivariate logistic regression analysis revealed that duration of disease and SDAI at 6months were significantly associated with the achievement of functional remission at 12months. The best cut-off value of SDAI at 6months for predicting functional remission at 12months was 15.7 by receiver operating characteristic curve analysis. HAQ-DI scores in the LDA group were significantly higher than those in the clinical remission group at 6 and 12months. The mean HAQ-DI score at 12months in the clinical remission group improved significantly relative to the mean HAQ-DI score at 6months in the LDA group. Our findings highlight the importance of achieving LDA at least by 6months after initiating biologics therapy, and achieving clinical remission as soon as possible, in order to minimize physical dysfunction in patients with early RA.