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Probability of continued low disease activity in patients with recent onset rheumatoid arthritis treated according to the Disease Activity Score
  1. S Martijn van der Kooij (smvanderkooij{at}lumc.nl)
  1. LUMC, Netherlands
    1. Y PM Goekoop-Ruiterman (y.p.m.goekoop{at}lumc.nl)
    1. LUMC, Netherlands
      1. J Kirsten De Vries-Bouwstra (jkdevriesbouwstra{at}lumc.nl)
      1. VUmc, Netherlands
        1. A J Peeters (peeters{at}rdgg.nl)
        1. Reinier de Graaf Hospital, Netherlands
          1. M V van Krugten (mvankrugten{at}zwv.nl)
          1. Walcheren Hospital, Netherlands
            1. F C Breedveld (f.c.breedveld{at}lumc.nl)
            1. University Hospital Leiden, Netherlands
              1. N AC Dijkmans (bac.dijkmans{at}vumc.nl)
              1. VUmc, Netherlands
                1. C F Allaart (c.f.allaart{at}lumc.nl)
                1. LUMC, Netherlands

                  Abstract

                  Objective: To assess the duration and the probability of maintaining low disease activity once a low disease activity score (DAS) is achieved in recent onset rheumatoid arthritis (RA) patients.

                  Methods: The BeSt study is a randomized trial comparing 4 different treatment strategies in patients with recent onset, active RA. Treatment adjustments were mandatory as long as the DAS was >2.4. If the DAS was ≤2.4, treatment was continued and after 6 months, tapered to maintenance dose. We analyzed three-monthly DAS calculations in order to assess the duration and the probability of maintaining a DAS ≤2.4.

                  Results: Patients treated with initial combination therapy achieved a DAS ≤2.4 significantly earlier than patients treated with initial monotherapy. Independent of treatment strategy and without treatment adjustments, the probability of a next DAS ≤2.4 three months after a first DAS ≤2.4 was 74%. The probability increased to 85% after 2 preceding DAS ≤2.4 and to 88-97% after 1-2 preceding DAS <1.6. The median duration of a DAS ≤2.4 was 12 months.

                  Conclusion: Once recent onset RA patients achieve a low DAS, the probability of maintaining a low DAS without treatment adjustments is high. This may have implications for the monitoring of patients in daily practice.

                  • disease activity score (DAS)
                  • recent onset rheumatoid arthritis
                  • treatment strategies

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