Article Text

AB0269 Favorable outcome, a new concept for the evaluation of health state in rheumatoid arthritis (RA): results from the french ESPOIR cohort
  1. C. Gaujoux-Viala1,
  2. L. Gossec2,
  3. M. Dougados2,
  4. B. Fautrel1
  1. 1Rheumatology, Pitié-Salpétriêre Hospital, UPMC
  2. 2Rheumatology B, Cochin Hospital, Paris-5 university, Paris, France


Background The relevant elements to evaluate health states in RA should include [ref]: a) Remission according to the new criteria of ACR/EULAR b) A criterion representing good functional ability: HAQ≤0.5 and HAQ deterioration≤0.25 c) A criterion representing structural damage: absence of progression of the Sharp score over 1 year. The concept of favorable outcome could then be defined by the association of these 3 elements. As remission is highly related to therapeutic decision-making, we may propose an alternative definition of favorable outcome keeping only the last 2 criteria (function and structure).

Objectives 1) To describe patients with favorable outcome according to the two definitions (ie using 2 and 3 criteria) at 1 year in early arthritis (EA) in daily clinical practice 2) To assess which variables at baseline are associated with favorable outcome at 1 year.

Methods Patients: from the French cohort of EA ESPOIR (at least 2 swollen joints for less than 6 months and suspicion of RA) and treated for at least 3 months with synthetic DMARDs (methotrexate, leflunomide or sulfazalasine) without biotherapy during the first year.

Data collected: at baseline, patients characteristics; every 6 months, bio-clinical variables and yearly, X-rays

Analysis: The characteristics and health status of patients with favorable outcome at 1 year (according to the two definitions, ie using 2 and 3 criteria) were analyzed. Multivariate logistic regression was used to determine which variables at baseline were independently associated with favorable outcome at 1 year according to the two definitions.

Results Within the first year of follow-up of 813 EA patients, 457 received at least 3 months of synthetic DMARDs. The mean age of patients was 49±12 years; 74% were women. At 1 year, 65 (15%) were in remission according to the new Boolean ACR/EULAR definition, 267 (61%) had favorable function criterion and 260 (65%) had no structural progression. In all, 157 (39%) presented favorable outcome using the 2 criteria (function+structure) and 44 (11%) presented favorable outcome using the 3 criteria (clinical remission+function+structure). In the logistic regression model, lower symptom duration, lower tender joint count, better perceived health state (EQ5D), and lower Sharp score were associated with favorable outcome using the 2 criteria (function+structure). In the logistic regression model, lower age, being married/in a common-law relationship and lower tender joint count (TJC) were associated with favorable outcome using the 3 criteria (Table).

Table 1. Significant determinants of favorable outcome at 1 year in multivariate analysis

Conclusions Favorable outcome appears to be achievable outcome in early RA: its predictors are close to the predictors of other validated outcomes, but favorable outcome may be a more relevant outcome in particular in terms of long-term prediction. Favorable outcome should be further assessed.

  1. Felson DT et al. Ann Rheum Dis 2011; 70(3):404-13

Disclosure of Interest None Declared

Statistics from

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.