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