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Aiming for SDAI remission versus low disease activity at 1 year after inclusion in ESPOIR cohort is associated with better 3-year structural outcomes
  1. Adeline Ruyssen-Witrand1,2,3,
  2. Gregory Guernec1,2,
  3. Delphine Nigon3,
  4. Gabriel Tobon4,
  5. Bénédicte Jamard3,
  6. Anne-Christine Rat5,
  7. Olivier Vittecoq6,
  8. Alain Cantagrel3,7,
  9. Arnaud Constantin1,2,3
  1. 1UMR 1027, INSERM, Toulouse, France
  2. 2UMR 1027, University Paul Sabatier Toulouse III, Toulouse, France
  3. 3Rheumatology Center, Purpan Hospital, Toulouse, France
  4. 4Rheumatology Department, Cavale Blanche Hospital, Brest, France
  5. 5Rheumatology Department, CHU Bravois, Vandoeuvre les Nancy, France
  6. 6Rheumatology Department, CHU de Rouen, Rouen, France
  7. 7JE2510, University Paul Sabatier Toulouse III, Toulouse, France
  1. Correspondence to Dr Adeline Ruyssen-Witrand, Rheumatology Center, Purpan Teaching Hospital, 1 place du Dr Baylac, Toulouse 31059, Cedex 9, France; adruyssen{at}hotmail.com

Abstract

Objectives Using data for patients with early rheumatoid arthritis (RA) from the ESPOIR cohort, we aimed to evaluate the impact of remission versus low disease activity (LDA) by the Simple Disease Activity Index (SDAI) at 1 year on 3-year structural damage assessed by the modified Sharp–van der Heijde total score (mTSS) and functional impairment assessed by the Health Assessment Questionnaire Disability Index (HAQ-DI).

Methods We included 625 patients from the ESPOIR cohort who fulfilled the 2010 American College of Rheumatology/European League Against Rheumatism criteria for RA at baseline and had an SDAI score at 1 year. mTSS and HAQ-DI scores were compared at 3 years for patients with SDAI remission or LDA status at 1 year. A linear mixed model was used to assess the independent effect of SDAI status at 1 year on mTSS and HAQ-DI at 3 years.

Results Of the 625 patients included (mean (SD) age 48.5 (12.1) years; 491 (78.6%) were women), 121 (19.4%) were in SDAI remission and 223 (35.7%) in LDA at 1 year. The mean (SD) mTSS and HAQ-DI score at 3 years was 9.6 (9.2) and 0.23 (0.42), respectively, for patients in remission at 1 year and 15.8 (16.1) and 0.43 (0.52), respectively, for patients with LDA (both p<0.05). Multivariate analysis revealed an association of remission rather than LDA status at 1 year and reduced mTSS score (p=0.005) but not HAQ-DI score (p=0.4) at 3 years.

Conclusions Aiming for SDAI remission rather than LDA at 1 year leads to better radiographic outcomes at 3 years in early RA patients.

  • Rheumatoid Arthritis
  • Outcomes research
  • Treatment

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