Background Ideally more patients with early rheumatoid arthritis (ERA) will obtain remission if we can predict very early in their disease course (such as by 3 months) who will be in a low disease state in the future (such as at one year) using clinical parameters and adjusting DMARD treatment for those who are not likely to obtain remission.
Objectives To determine predictors of 1-year remission in early rheumatoid arthritis (ERA) using baseline and 3 months data.
Methods The Canadian Early Arthritis Cohort (CATCH) patients were included if baseline, 3 and 12 months data were available. Regression analyses for four different definitions of remission at 12 months were done to determine baseline and 3 months predictors of remission.
Results 579 had 12 months data; mean age 52.6 years, disease duration 6.2, 73% were female. The factors at baseline associated with all four remission outcomes at 12 months were age, gender, TJC, physician global assessment (MDGA), patient global assessment (PTGA), HAQ and pain. Baseline ESR was associated with DAS28 remission only and SJC was associated with CDAI and SDAI remission. At 3 months, all four remission definitions were associated with: age, gender, TJC, SJC, MDGA, PTGA, HAQ, pain, ESR and CRP in univariate analyses. In the regression model, variables associated with SDAI remission were MDGA (OR 0.76, p<0.001), pain (OR 0.86, p=0.008), HAQ (OR 0.49, p=0.010) and age (OR 0.98, p=0.043); CDAI remission was associated with MDGA (OR 0.73, p<0.001), pain (OR 0.87, p=0.009), and HAQ (OR 0.52, p=0.013). DAS28 remission was predicted by ESR (OR 0.95, p<0.001), MDGA (OR 0.78, p<0.001), age (OR 0.97, p=0.001), HAQ (OR 0.54, p=0.002) and male (OR 1.99, p=0.007), whereas Boolean remission was associated with PTGA (OR 0.75, p<0.001), MDGA (OR 0.83, p=0.007), and HAQ (OR 0.49, p=0.015). Table: Multivariate Analysis of Predictors of Remission at 12 months using data from 3 months.
Conclusions A low MDGA at 3 months was consistently associated with 1-year remission in ERA.
Disclosure of Interest T. Choy Grant/research support from: Schulich Research Training Program (SRTP) grant from UWO, V. Bykerk: None Declared, B. Haraoui: None Declared, G. Boire: None Declared, C. Hitchon: None Declared, C. Thorne: None Declared, E. Keystone: None Declared, J. Pope Grant/research support from: The CATCH study was designed and implemented by the investigators and financially supported initially by Amgen Canada Inc. and Pfizer Canada Inc. via an unrestricted research grant since inception of CATCH. As of 2011, further support was provided by Hoffmann-La Roche Ltd., United Chemicals of Belgium (UCB) Canada Inc., Bristol-Myers Squibb Canada Co., Abbott Laboratories Ltd., and Janssen Biotech Inc. (a wholly owned subsidiary of Johnson & Johnson Inc.).