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    Remission vs low disease activity: function, quality of life and structural outcomes in the Early Rheumatoid Arthritis Study and Network

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    Author
    Walsh, David A
    Keyword
    Damage
    Function
    Life quality
    Low disease activity
    Remission
    Rheumatoid arthritis
    Date
    2020-06
    
    Metadata
    Show full item record
    Publisher's URL
    https://academic.oup.com/rheumatology/article/59/6/1272/5580604
    Abstract
    Objectives: To examine associations between function, quality of life and structural outcomes in patients achieving remission vs low disease activity in early RA. Methods: Demographic, clinical and radiographic variables were collected at baseline and then annually from the Early Rheumatoid Arthritis Study (ERAS) and Early Rheumatoid Arthritis Network (ERAN) inception cohorts in routine care from 1986 to 2012. Disease activity was categorized: mean DAS28 score between years 1 and 5: remission [mean remission DAS (mRDAS) <2.6] or low [mean low DAS (mLDAS) 2.6-3.2]; sustained low/remission DAS28 (sLDAS/sRDAS) at years 1 and 2; and sustained Boolean remission (sBR) at years 1 and 2. Changes in HAQ and Short Form 36 Health Survey Questionnaire [SF-36; physical (PCS) and mental (MCS) component score]) and total Sharp van der Heijde (SvdH) scores for each disease activity category were modelled using multi-level models. Covariates included year of onset, age, gender and DMARD use at first visit. Results: Of 2701 patients, 562 (21%) were categorized mRDAS, 330 (12%) mLDAS, 279 (10%) sRDAS, 203 (7.5%) sLDAS and 93 (3%) sBR. Patients categorized as mRDAS had increasingly divergent improved HAQ, SF-36 PCS, MCS and total SvdH scores compared with mLDAS (P-values 0.001 to <0.0001, all time points). Patients categorized as sRDAS had better HAQ, SF-36 PCS and MCS scores (P-values 0.05 to <0.0001, all time points) and SvdH scores (P = 0.05, years 3-5) over sLDAS. sBR was associated with better HAQ, and SF-36 PCS and MCS scores over sLDAS (P-values 0.002 to <0.0001, all time points). Conclusion: These findings from routine care support ACR/EULAR guidelines that remission is a preferable goal over low disease activity in early RA.
    Citation
    Nikiphorou, E. et al. (2020) ‘Remission vs low disease activity: function, quality of life and structural outcomes in the Early Rheumatoid Arthritis Study and Network’, Rheumatology, 59(6), pp. 1272–1280
    Publisher
    Reumatology
    Type
    Article
    URI
    http://hdl.handle.net/20.500.12904/15590
    Collections
    Rheumatology

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