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Gender- a major predictor of remission in early rheumatoid arthritis?
  1. Kristina Forslind
  1. Section of Rheumatology, Helsingborgs lasarett, Helsingborg, Sweden
    1. Ingiäld Hafström
    1. Rheumatology Department, Karolinska University Hospital Huddinge, Stockholm, Sweden
      1. Monica Ahlmén
      1. Rheumatology Department, Sahlgrenska University Hospital/Mölndal, Sweden
        1. Björn Svensson (bjosve{at}telia.com)
        1. Rheumatology Department, University Hospital, Lund, Sweden

          Abstract

          Objectives: The treatment goal of early rheumatoid arthritis (RA) is remission. This study reports remission rates in clinical practice using a cohort of patients with early RA.

          Methods: 698 patients with early RA were included. Mean age at inclusion was 58 years, mean disease duration was 6,4 months, 64 % of the patients were women, 56 % were anti-CCP positive and 60 % RF positive. Remission was defined as a disease activity score (DAS28) below 2.6, with or without ongoing RA medication.

          Results: After 2 years 261 of 689 patients were in remission (37,9%), and after 5 years the remission rate was 38,5%. However, only 26.1% were in remission at both these time points. Multiple logistic regression analyses found gender to be a main predictor for remission. Thus, significantly fewer women were in remission: after 2 years, 32,1% vs 48%, p=0.0005, and after 5 years 30,8% vs 52,4%, p=0.0005, and at both these time points 19,1% vs 39,3%, p=0.0005. Although disease activity was not with certainty more pronounced in women at disease onset, the disease course became significantly worse in women. The disparity in remission frequency between women and men could not be explained by differences in disease duration, age or treatment with DMARDs or glucocorticoids.

          Conclusions: In this study on early RA remission by DAS28<2.6 was as frequent or more frequent than in most previous reports. Importantly, women suffered a more severe disease with a significantly lower remission rate than men although the disease activity before treatment appeared similar.

          • RA, remission, gender, DAS28, HAQ

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