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Study: Maintenance of remission should be treatment goal for patients with RA
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Patients with sustained remission from rheumatoid arthritis had better Health Assessment Questionnaire scores than patients who occasionally achieved remission, according to recently published results.
Researchers studied 2,416 patients with rheumatoid arthritis (RA) from the South Swedish Arthritis Treatment Group (SSATG) register. Of these patients, 1,178 reached DAS28 remission at some time between March 1999 and December 2009 while under treatment with tumor necrosis factor inhibitors. Disease activity was evaluated using the American College of Rheumatology (ACR)/European League Against Rheumatism Clinical Disease Activity Index (CDAI) and the Simplified Disease Activity Index (SDAI). Remission was defined as a DAS28 of up to 2.6, an SDAI of up to 3.3 and a CDAI of up to 2.8. Sustained remission was defined as remission criteria at least two consecutive times for at least 6 months following at least 3 months of treatment.
Sustained remission was met by 382 patients by DAS28 criteria, by 186 of patients for SDAI criteria and by 177 of patients for CDAI criteria. At the beginning of remission, patients with RA had lower mean Health Assessment Questionnaire (HAQ), SDAI and CDAI scores compared to patients who did not achieve sustained remission. After 4 years of sustained remission, 40% of patients with RA had full physical function compared to 10.4% of patients who did not achieve remission. After 6 years in SDAI remission, 60% of patients had full physical function compared to 43% of patients in DAS28 remission.
“Results from our present study indicate that only occasionally reaching remission might not be enough, but for improved physical function, remission should be sustained,” the researchers wrote. “Because the functional status is highly comparable between different remission definitions, the issue of the sustainability of disease remission might be more important than the choice of remission criteria.”
Disclosure: The researchers report no relevant financial disclosures.
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