Abstract
IntroductionThough remission is currently a treatment goal in patients with rheumatoid arthritis (RA), the number of patients who achieve and sustain remission in daily practice is still small. It is suggested that early remission will be associated with sustainability of remission. The aim was to study the association between time-to-remission and sustainability of remission in a cohort of early RA patients treated according to daily practice.MethodsFor this study, three-year follow-up data were used from the Nijmegen RA Inception Cohort of patients included between 1985 and 2005 (N = 753). Patients were included upon diagnosis (ACR criteria), were systematically evaluated at three-monthly visits and treated according to daily practice. Remission was defined according to the Disease Activity Score (DAS) <1.6 and the ACR remission criteria. Remission of at least 6 months duration was regarded as sustained remission. Predictors for time-to-remission were identified by Cox-regression analyses. The relation between time-to-remission and sustained remission was analyzed using longitudinal binary regression.ResultsN = 398 (52%) patients achieved remission with a median time-to-remission of 12 months. Male gender, younger age and low DAS at baseline were predictive to reach remission rapidly. There were n = 142 (36%) patients experiencing sustained remission, which was determined by a shorter time-to-remission only. The relationship between time-to-remission and sustained remission was described by a significant odds ratio (1.11) (1.10 to 1.12-95% CI) that was constant over the whole period 1985 to 2005. Results obtained with the ACR remission criteria were similar.ConclusionsA shorter time-to-remission is related to sustainability of remission, supporting striving for early remission in patients with RA.
Highlights
Though remission is currently a treatment goal in patients with rheumatoid arthritis (RA), the number of patients who achieve and sustain remission in daily practice is still small
Patients, who were not included in this study, did not differ significantly or remarkably from patients who were included with respect to age, gender, rheumatoid factor positivity, disease duration, Disease Activity Score (DAS), HAQ, medication use and change in DAS between baseline and six months
DAS = disease activity score based on 53 tender joint counts (Ritchie Articular Index) and 44 swollen joint counts; DAS28 = disease activity score based on 28 tender and swollen joint counts; HAQ = health assessment questionnaire; ESR = erythrocyte sedimentation rate; CRP = C-reactive protein; Visual Analogue Scale (VAS) = visual analogue scale.IQR = interquartile range, P25-P75; SD = standard deviation
Summary
Though remission is currently a treatment goal in patients with rheumatoid arthritis (RA), the number of patients who achieve and sustain remission in daily practice is still small. The aim was to study the association between time-to-remission and sustainability of remission in a cohort of early RA patients treated according to daily practice. Expectations considering the treatment effect of rheumatoid arthritis (RA) have changed and aiming for clinical remission is currently regarded as an appropriate treatment goal in patients with early RA[1]. The number of patients who achieve remission in routine care is small and only a minority of these patients reach sustained remission [2,3]. It is a near-remission disease state that currently is an achievable treatment goal in daily practice.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
