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Younger age, earlier sustained response predicted better outcomes for RA patients
Younger patients with early rheumatoid arthritis and lower disease activity achieved earlier sustained response that served as a predictor for a favorable outcome for the disease, according to study results.
Researchers collected and analyzed data from 89 patients with early rheumatoid arthritis (RA) to determine predictors of favorable outcomes. The mean age of the study patients was 38.8 years. The patients, mostly females (n=78), had undergone 3 years of assessment follow-ups and had been treated with disease-modifying anti-rheumatic drugs (DMARDs). Researchers defined sustained remission (SR) as being at least 6 months (three consecutive visits at 2 months apart) with scores on the 28 tender joint counts, 28 swollen joint counts, C-reactive protein and overall patient disease activity all less than or equal to 1. An excellent outcome (EO) was based upon a patient’s perception, plus descriptive statistics, logistic regression models and Cox proportional hazard model. When patients achieved more than 60% of their follow-up in remission, an EO was determined.
Seventy-five patients achieved at least one period of SR, with two patients reaching three periods of SR. Those who achieved at least one SR showed lower disease activity, disability and comorbidity than their counterparts (P≤.05). Lower C-reactive protein levels, disease activity and comorbidity also predicted SR (P≤.04). Researchers found the 35 patients who reached EO were better educated, younger, had lower disease activity and better functional status at baseline (P≤.05).
In determining predictors for EO, researchers said age (HR=0.95; 95% CI, 0.91-0.98), along with an earlier SR achievement (HR=0.49; 95% CI, 0.39-0.61) were statistically significant.
“Our study showed that a substantial proportion of early RA patients who received treatment with DMARDs achieved at least one sustained remission state,” researchers said. “RA treatment should be directed to achieve a rapid and sustained response as it predicts, along with younger age, a longstanding excellent outcome.”