Background Remission in rheumatoid arthritis (RA) is increasingly possible in recent years with a treat-to-target strategy. It would be of value to recognize baseline variables that are potential predictors of remission.
Objectives To analyze baseline RA core data set and demographic variables as potential predictors of remission at 6 or 12 months in the ESPOIR usual care cohort of early RA.
Methods The ESPOIR usual care cohort includes patients with early RA who had baseline DAS28 ≥5.1. Three remission criteria were studied: ACR/EULAR Boolean – most stringent “gold standard” ; DAS28 ≤2.6 – predictors of remission in early RA have been reported ; and RAPID3RJ1 (RAPID3 ≤3 and ≤1 swollen joint) – similar results to the Boolean criteria . Baseline variables were compared according to remission status 6 or 12 months later for each of 3 criteria, using univariate and multivariate regression models.
Results 664 patients had available data. Remission at either 6 or 12 months was seen in 165 patients (24.8%) by Boolean criteria, 339 (51.4%) by DAS28, and 209 (31.5%) by RAPID3RJ1. Age and tender joint count were associated independently with remission by all 3 criteria in multivariate analyses (Table). Female gender, family history of RA, patient and physician global estimates, physical function, swollen joint counts and ESR were predictive in some models, although odds ratios were not substantial. Disease duration, radiographic erosions, CRP, anti-CCP and rheumatoid factor were not significant to predict remission by any of the 3 criteria, and therefore not entered into any multivariate models.
Conclusions Younger age and lower initial number of tender joints were significant, while erosions, CRP, anti-CCP and rheumatoid factor were not significant to predict RA remission 6 or 12 months later according to any of the 3 criteria.
Felson DT, Smolen JS, Wells G, et al. Arthritis Rheum 2011;63:573-86.
Ma MH, Ibrahim F, Walker D, et al. J Rheumatol 2012;39:470-5.
Castrejón I, Dougados M, Combe B, et al. J Rheumatol 2013; in press.
Disclosure of Interest None Declared