Article Text

PDF
SAT0090 Three out of Every Four Patients with Dmard-Naive Early Rheumatoid Arthritis Meet DAS28 Remission at 12 Months in Finland
  1. T. Rannio1,
  2. J. Asikainen1,
  3. P. Hannonen1,
  4. T. Yli-Kerttula2,
  5. P. Ekman2,
  6. L. Pirilä3,
  7. L. Kuusalo3,
  8. M. Mali3,
  9. M. Puurtinen-Vilkki3,
  10. S. Kortelainen3,
  11. J. Paltta3,
  12. K. Taimen3,
  13. M. Kauppi4,
  14. K. Laiho4,
  15. S. Nyrhinen4,
  16. H. Mäkinen5,
  17. P. Isomäki5,
  18. T. Uotila5,
  19. K. Aaltonen6,
  20. H. Kautiainen6,
  21. T. Sokka7
  1. 1Rheumatology, Central Hospital of Central Finland, Jyväskylä
  2. 2Rheumatology, Central Hospital of Rauma, Rauma
  3. 3Rheumatology, Turku University Hospital, Turku
  4. 4Rheumatology, Päijät-Häme Central Hospital, Lahti
  5. 5Rheumatology, Tampere University Hospital, Tampere
  6. 6University of Helsinki, Helsinki
  7. 7Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland

Abstract

Background Finnish national combination treatment trials [1,2] have demonstrated excellent outcomes in patients with early rheumatoid arthritis (RA) including 90% of patients reaching 28-joint Disease Activity Score (DAS28) remission. Whether similar results are reached in clinical praxis is not known.

Objectives To assess what proportion of patients with dmard-naïve early rheumatoid artritis (RA) reach DAS28 remission over one year and remission variability across clinics in Finland

Methods Patients with dmard-naïve inflammatory arthritis diagnosed as new early RA were recruited. Comparison among sites were made in proportion of patients in 28-joint Disease Activity Score with 3 variables (DAS28–3) remission. Repeated measures were analyzed using mixed models approach with appropriate distribution and link function.

Results 611 patients were recruited at 5 sites: 67% female; the mean age (SD) at diagnosis was 57 (16) years; respective 71% and 68% were RF and AntiCCP positive; 23% had radiographic erosions. A total of 506 (83%) fulfilled the ACR/EULAR 2010 classification criteria for RA for further analyses. DAS28–3 remission was met by 68% and 75% at 3 and 12 mo, respectively. Clinic had no effect in remission when adjusted for confounders (Figure 1). At baseline, a total of 68% used MTX based combination therapy, and 31% used triple therapy with methotrexate, hydroxychloroquine and sulphasalazine. In multivariate analysis, the only independent predictors of DAS28–3 remission at 12 mo were lower baseline DAS28–3 (odds ratio 0.6, 95% confidence interval 0.4–0.7, P<0.001) and triple therapy as the initial treatment (odds ratio 1.8, 95% confidence interval 1.0–3.3, P=0.048).

Conclusions Three out of every four dmard-naïve early RA patients are in remission in Finland after 1 year of diagnosis. High remission rates were achieved with use of csDMARDs in combinations for majority of patients. Treatment with triple therapy is a predictor of DAS28–3 remission also in real-life rheumatology settings.

  1. Möttönen T, Hannonen P, Leirisalo-Repo M, Nissilä M, Kautiainen H, Korpela M, et al. Comparison of combination therapy with single-drug therapy in early rheumatoid arthritis: A randomised trial. FIN-RACo trial group. Lancet 1999; 353:1568–73

  2. Leirisalo-Repo M, Kautiainen H, Laasonen L, Korpela M, Kauppi MJ, Kaipiainen-Seppänen O, et al. Infliximab for 6 months added on combination therapy in early rheumatoid arthritis: 2-year results from an investigator-initiated, randomised, double-blind, placebo-controlled study (the NEO-RACo Study). Ann Rheum Dis 2013;72:851–7

Acknowledgement We would like to thank study nurses. This study was supported by Pfizer.

Disclosure of Interest None declared

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.