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DAS28, anti-CCP predicted 10-year outcomes in synovitis suppression in patients with RA

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WASHINGTON — The disease activity score remission rate among a cohort of patients with rheumatoid arthritis in Denmark was 76%, according to findings presented at the American College of Rheumatology Annual Meeting.

Merete Lund Hetland, MD, and colleagues aimed to investigate outcomes of at least 10 years in goal-directed synovitis suppression in early rheumatoid arthritis (RA). The initial CIMESTRA trial was a 2-year, double-blinded, multicenter study that compared methotrexate (MTX) with MTX and cyclosporine as combination therapy with intra-articular glucocorticoids. In the current data set, Hetland and colleagues sought to investigate the clinical and radiographic status of 96 patients who remained from the original cohort of 120 patients, and to identify baseline predictors of functional status and erosive progression.

“Previous main results of CIMESTRA showed that disease control was excellent after 2 years,” Hetland said, noting an approximate 50% remission rate. There were 139 patients with continuously good disease control who remained through 5 years of follow-up

Results of the current analysis indicated a 76% DAS28 remission rate. The ACR/EULAR remission rate was 21.9%. Health assessment questionnaire (HAQ) scores were also normal, according to Hetland.

Nearly half of the remaining cohort (45%) were still using MTX, while 8.3% were using triple therapy; 20% were using biologics; and 26.7% were experiencing drug-free remission.

Multivariable analysis results indicated two variables predicted outcomes: DAS28; and anti-cyclic citrullinated peptide (CCP). Researchers also calculated predictors of change in Total Sharp Score (TSS). Those factors included bone marrow edema and anti-CCP.

“Ten years after initiating a Danish 2-year target-to-treat randomized controlled trial in patients with RA, 76% achieved DAS28 remission with low HAQ scores,” Hetland concluded. “Baseline predictors of functional status included DAS28 and anti-CCP. Predictors of radiographic progression included bone marrow edema and anti-CCP.” — by Rob Volansky

Reference:

Hetland ML, et al. Abstract #3210. Presented at: The American College of Rheumatology Annual Meeting; Nov. 11-16, 2016; Washington.

Disclosure: Hetland reports associations with AbbVie, BMS, Crescendo, MSD, Pfizer, Roche and UCB.