Probability of continued low disease activity in patients with recent onset rheumatoid arthritis treated according to the Disease Activity Score

S M van der Kooij ^1*, Y PM Goekoop-Ruiterman ¹, J K De Vries-Bouwstra ², A J Peeters ³, M V van Krugten ⁴, F C Breedveld ⁵, B AC Dijkmans ² and C F Allaart ¹

¹ LUMC, Netherlands
² VUmc, Netherlands
³ Reinier de Graaf Hospital, Netherlands
⁴ Walcheren Hospital, Netherlands
⁵ University Hospital Leiden, Netherlands

^* To whom correspondence should be addressed. E-mail: smvanderkooij{at}lumc.nl.

Accepted 2 October 2007

Abstract

Objective: To assess the duration and the probability of maintaining low disease activity once a low disease activity score (DAS) is achieved in recent onset rheumatoid arthritis (RA) patients.

Methods: The BeSt study is a randomized trial comparing 4 different treatment strategies in patients with recent onset, active RA. Treatment adjustments were mandatory as long as the DAS was >2.4. If the DAS was 2.4, treatment was continued and after 6 months, tapered to maintenance dose. We analyzed three-monthly DAS calculations in order to assess the duration and the probability of maintaining a DAS 2.4.

Results: Patients treated with initial combination therapy achieved a DAS 2.4 significantly earlier than patients treated with initial monotherapy. Independent of treatment strategy and without treatment adjustments, the probability of a next DAS 2.4 three months after a first DAS 2.4 was 74%. The probability increased to 85% after 2 preceding DAS 2.4 and to 88-97% after 1-2 preceding DAS <1.6. The median duration of a DAS 2.4 was 12 months.

Conclusion: Once recent onset RA patients achieve a low DAS, the probability of maintaining a low DAS without treatment adjustments is high. This may have implications for the monitoring of patients in daily practice.

Keywords: disease activity score (DAS), recent onset rheumatoid arthritis, treatment strategies

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Vliet Vlieland, T. P M, Huizinga, T. W J (2009). Quality indicators in rheumatology: valid for whom?. Ann Rheum Dis 68: 1797-1799 [Full Text]  
• GULFE, A., KRISTENSEN, L. E., GEBOREK, P. (2009). Six and 12 Weeks Treatment Response Predicts Continuation of Tumor Necrosis Factor Blockade in Rheumatoid Arthritis: An Observational Cohort Study from Southern Sweden. The Journal of Rheumatology 36: 517-521 [Abstract] [Full Text]