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FRI0117 Chronological changes in achieving j-haq remission in patients with early-stage rheumatoid arthritis in the iorra cohort
  1. M Ochiai1,
  2. E Tanaka1,
  3. E Inoue1,2,
  4. R Yamaguchi1,
  5. Y Shimizu1,
  6. N Sugimoto1,
  7. K Ikari1,
  8. A Nakajima1,
  9. A Taniguchi1,
  10. H Yamanaka1
  1. 1Rheumatology, Institute of Rheumatology Tokyo Women's Medical University
  2. 2Center for Clinical Research for Development, National Center for Child Health and Development, Tokyo, Japan

Abstract

Background With the introduction of biologic disease-modifying antirheumatic drugs (DMARDs) and the increase in the approved maximum dose of methotrexate in our country, the treatment of rheumatoid arthritis (RA) has advanced dramatically in the past 2 decades. Consequently, many patients were able to achieve clinical remission and low radiographic progression rates1–3. In view of these dramatic changes in RA treatment, we investigated whether the Japanese version of the Health Assessment Questionnaire (J-HAQ) improved chronologically due to improved treatment over time.

Objectives To investigate chronological changes in achieving J-HAQ remission and the factors related to J-HAQ remission in Japanese patients with an early stage of RA.

Methods RA patients who enrolled in the IORRA cohort for the first time between 2000–2002 (Term 1), 2005–2007 (Term 2), and 2010–2012 (Term 3) and were within 2 years of disease onset were examined. For each patient in Term 3, one patient was extracted from Term 1 and Term 2 by matching the sex, age, and J-HAQ score. Among them, patients with J-HAQ >0.5 at study entry (baseline) were selected; the time to achieve J-HAQ remission (J-HAQ ≦0.5) and the J-HAQ remission rate at 3 years were analyzed. Multivariate analysis was performed to assess factors related to achieving J-HAQ remission.

Results In each term, 348 RA patients were extracted. At baseline, the average J-HAQ of all 1,044 patients was 0.52. Baseline characteristics of 408 patients with baseline J-HAQ >0.5 were as follows: female, 89.0%; mean age, 56.3 years; anti-cyclic citrullinated peptide (anti-CCP) antibody positivity, 78.0%; mean Disease Activity Score with 28-joint count (DAS28), 4.37; and mean J-HAQ, 1.11. The mean time from baseline to achieving J-HAQ remission became significantly shorter chronologically (Term 1: 2.2 years; Term 2: 1.8 years; Term 3: 1.7 years; p<0.005, Fig.1). J-HAQ remission rates significantly increased in both Term 2 (55.2%) and Term 3 (57.4%) compared with Term 1 (37.5%; p<0.005). The factors significantly related to achieving J-HAQ remission at 3 years were younger age (OR 1.02; 95% CI 1.00–1.04) and enrollment in Term 2 (OR 2.0; 95% CI 1.2–3.5) or Term 3 (OR 2.3; 95% CI 1.3–4.1) compared with enrollment in Term 1.

Conclusions Along with the improvement in RA treatment, patients were able to achieve J-HAQ remission more frequently and more quickly.

References

  1. Mod Rheumatol. 2007;17:283–9.2) J Rheumatol. 2015; 42:2279–87.3) Rheumatology. 2016;55:1053–1065.

References

Disclosure of Interest M. Ochiai: None declared, E. Tanaka Consultant for: Abbvie, Eisai Pharmaceutical, Chugai Pharmaceutical, Bristol Myers Squibb, Astellas Pharmaceutical, Pfizer, Takeda Pharmaceutical, and Ayumi Pharmaceutical., Speakers bureau: Abbvie, Eisai Pharmaceutical, Chugai Pharmaceutical, Bristol Myers Squibb, Astellas Pharmaceutical, Pfizer, Takeda Pharmaceutical, and Ayumi Pharmaceutical., E. Inoue: None declared, R. Yamaguchi: None declared, Y. Shimizu: None declared, N. Sugimoto Speakers bureau: Takeda Pharmaceutical and Bristol Myers Squibb., K. Ikari Grant/research support from: Astellas, UCB, Bristol-Meyers, Pfizer, Eisai, Tanabe-Mitsubishi, Chugai, AbbVie, Janssen Pharmaceutical, Otsuka, Kaken, Asahi-Kasei, Hisamitsu and Takeda., Speakers bureau: Astellas, UCB, Bristol-Meyers, Pfizer, Eisai, Tanabe-Mitsubishi, Chugai, AbbVie, Janssen Pharmaceutical, Otsuka, Kaken, Asahi-Kasei, Hisamitsu and Takeda., A. Nakajima Consultant for: Bristol-Meyers, Mitsubishi Tanabe Pharma, Nippon Kayaku Co. Ltd., Novartis Pharma, Pfizer, Siemens Healthcare Diagnostics K.K. and Takeda Pharmaceutical Company, Speakers bureau: Bristol-Meyers, Mitsubishi Tanabe Pharma, Nippon Kayaku Co. Ltd., Novartis Pharma, Pfizer, Siemens Healthcare Diagnostics K.K. and Takeda Pharmaceutical Company, A. Taniguchi Grant/research support from: AbbVie, Eisai, Takeda, Tanabe-Mitsubishi, Teijin Pharma, Pfizer., Speakers bureau: AbbVie, Eisai, Takeda, Tanabe-Mitsubishi, Teijin Pharma, Pfizer., H. Yamanaka Grant/research support from: MSD, Ayumi, AbbVie, Eisai, Ono, Astellas, Daiichi-Sankyo, Taisyo-Toyama, Takeda, Tanabe-Mitsubishi, Chugai, Teijin Pharma, Torii, Nippon Shinyaku, Pfizer. UCB. Nippon Kayaku, YL biologics, Bayer and Bristol-Meyers., Consultant for: MSD, Ayumi, AbbVie, Eisai, Ono, Astellas, Daiichi-Sankyo, Taisyo-Toyama, Takeda, Tanabe-Mitsubishi, Chugai, Teijin Pharma, Torii, Nippon Shinyaku, Pfizer. UCB. Nippon Kayaku, YL biologics, Bayer and Bristol-Meyers., Speakers bureau: MSD, Ayumi, AbbVie, Eisai, Ono, Astellas, Daiichi-Sankyo, Taisyo-Toyama, Takeda, Tanabe-Mitsubishi, Chugai, Teijin Pharma, Torii, Nippon Shinyaku, Pfizer. UCB. Nippon Kayaku, YL biologics, Bayer and Bristol-Meyers.

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