Objectives To compare clinical features in patients with RA classified by ACR/EULAR (A/E) remission and mHAQ≤0.5, and to explore clinical factors for reaching or maintaining the remission.
Methods Data of 831 patients receiving MTX monotherapy for a continuous period of 3 years from 2008 were extracted from Ninja 2010, an annually updated nationwide database in Japan. The patients were divided into four groups according to their remission states, both A/E and HAQ remission (A), only A/E remission (B), only HAQ remission (C) and neither A/E nor HAQ remission (D). Total joint index (TJI) was calculated as the sum of tender and swollen joint counts divided by the number of evaluable joints in the region of interest (1).
Results Clinical features of the 4 groups were different (table 1). SDAI was different in each groups whereas DAS28 did not differ between the group A and B, and between the group C and D.
The majority of patients remained in their groups throughout the period, and a transition between the group A and C occurred in around 20% of patients. Patients remained in the group A for at least 2 years had higher rate of mHAQ=0 and lower levels of physician global assessment and SDAI than patients moved from the group A to C. Patients moved from the group C to A had low levels of pain VAS, patient global assessment, physician global assessment, DAS28, and SDAI and possessed low rate of TJI>0 in upper/large and upper/small regions compared to patients remained in the group C for at least 2 years.
Conclusions Clinical features were different between the 4 groups classified according to A/E and HAQ remission states. Patients that achieved and/or maintained both A/E and HAQ remission shared common features of low levels of physician global assessment and SDAI.
Nishiyama S, et al, Proposing a method of regional assessment and a novel outcome measure in rheumatoid arthritis. Rheumatol Int. DOI 10.1007/s00296-011-2058-9, 2011
Disclosure of Interest None Declared