Abstract
Objectives:The Simplified Disease Activity Index (SDAI) 50 has good agreement with European League Against Rheumatism (EULAR) response measures for early Rheumatoid Arthritis (RA). There have been reports on early RA, but not on long-established RA. In this study, we analysed the relationships between various baseline factors and SDAI 50 after three months of treatment with biological disease-modifying antirheumatic drugs (bDMARDs) to determine the prognostic factors for long-established RA.Methods:Subjects were 260 RA patients who had been treated with bDMARDs for 3 months. The following characteristics were investigated: Patient backgrounds, the erythrocyte sedimentation rate (ESR), C-reactive protein and serum matrix metalloproteinase-3 levels, SDAI scores, and health assessment questionnaire disability index and short form-36 scores. As a primary outcome index, the SDAI response was defined as a 50% reduction in the SDAI score between baseline and 3 months (SDAI 50).Results:Baseline values of disease duration (odds ratio: 0.942, 95% CI: 0.902-0.984), smoking history (odds ratio: 2.272, 1.064-4.850), 28-tender joint count (odds ratio: 0.899, 0.827-0.977), evaluator's global assessment (odds ratio: 1.029, 1.012-1.047) and ESR (odds ratio: 1.015, 1.001-1.030) were determined to be significant factors based on logistic regression analysis.Conclusion:Our study demonstrated that RA patients with shorter disease duration, no smoking, and higher RA disease activity are more likely to achieve SDAI 50 through bDMARD treatment.
Highlights
Recommendations for the treatment of rheumatoid arthritis (RA) are well established [1]
As a primary outcome index, the Simplified Disease Activity Index (SDAI) response was defined as a 50% reduction in the SDAI score between baseline and 3 months (SDAI 50)
Baseline values of disease duration, smoking history, 28tender joint count, evaluator's global assessment and erythrocyte sedimentation rate (ESR) were determined to be significant factors based on logistic regression analysis
Summary
Recommendations for the treatment of rheumatoid arthritis (RA) are well established [1]. The use of methotrexate (MTX) as an anchor agent, in combination with biological disease-modifying antirheumatic drugs (bDMARDs), has contributed to an increasing number of patients who achieve clinical remission. As a result of this increase in the rate of clinical remission, the number of patients achieving structural and functional remission has increased [2]. Complete remission in a patient is defined as the achievement of clinical, structural, and functional remission [3]. SDAI 50 by bDMARDs in Long-Established RA. Female sex, longer symptom duration and younger age predict a worse response to MTX in patients with new onset RA [6]. Aiming for Simplified Disease Activity Index (SDAI) [7]remission at month 6 is an appropriate strategy to obtain good functional and structural outcomes at month 12 [8]. Greater pain, and a lack of initial DMARD therapy reduced the probability of sustained remission [9]
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