OBJECTIVES: To compare the prevalence of and predictors for sustained drug-free remission in two cohorts of patients with recent-onset RA treated with DAS-driven therapy or non-DAS-driven therapy. METHODS: Sustained drug-free remission was assessed after 5 years of follow-up in 508 patients treated with DAS-driven therapy (DAS ≤ 2.4) in a randomized treatment cohort, and in 424 patients who received non-DAS-driven therapy in a prospective inception cohort. The design of the DAS-driven cohort required systematic joint assessments with DAS-driven restart of therapy. Predictors for remission were identified by univariable and multivariable logistic regression in each cohort separately and in a combined multivariate logistic regression analysis corrected for propensity scores, including a sensitivity analysis on patients receiving initial monotherapy. RESULTS: Patients in the DAS-driven cohort had more active disease at baseline, but the prevalence of sustained drug-free remission was similar after DAS-driven (9.8%) and non-DAS-driven therapy (10.6%). Among patients with ACPA, drug-free remission was more frequently achieved after DAS-driven than after non-DAS-driven therapy (5.4 vs. 2.1%, OR = 2.68, 95% CI 0.97, 7.43). Absence of ACPA and short symptom duration were independent predictors for sustained drug-free remission in both cohorts. Initial treatment choice and inclusion period were not predictive. The sensitivity analysis yielded comparable results. CONCLUSION: Retrospectively comparing a DAS-driven to a non-DAS-driven therapy cohort, the occurrence and predictors of sustained drug-free remission were similar. The DAS-driven cohort had a more unfavourable prognosis. DAS-driven therapy may improve the chance of sustained drug-free remission in ACPA-positive patients with recent-onset RA.
OBJECTIVES: To compare the prevalence of and predictors for sustained drug-free remission in two cohorts of patients with recent-onset RA treated with DAS-driven therapy or non-DAS-driven therapy. METHODS: Sustained drug-free remission was assessed after 5 years of follow-up in 508 patients treated with DAS-driven therapy (DAS ≤ 2.4) in a randomized treatment cohort, and in 424 patients who received non-DAS-driven therapy in a prospective inception cohort. The design of the DAS-driven cohort required systematic joint assessments with DAS-driven restart of therapy. Predictors for remission were identified by univariable and multivariable logistic regression in each cohort separately and in a combined multivariate logistic regression analysis corrected for propensity scores, including a sensitivity analysis on patients receiving initial monotherapy. RESULTS:Patients in the DAS-driven cohort had more active disease at baseline, but the prevalence of sustained drug-free remission was similar after DAS-driven (9.8%) and non-DAS-driven therapy (10.6%). Among patients with ACPA, drug-free remission was more frequently achieved after DAS-driven than after non-DAS-driven therapy (5.4 vs. 2.1%, OR = 2.68, 95% CI 0.97, 7.43). Absence of ACPA and short symptom duration were independent predictors for sustained drug-free remission in both cohorts. Initial treatment choice and inclusion period were not predictive. The sensitivity analysis yielded comparable results. CONCLUSION: Retrospectively comparing a DAS-driven to a non-DAS-driven therapy cohort, the occurrence and predictors of sustained drug-free remission were similar. The DAS-driven cohort had a more unfavourable prognosis. DAS-driven therapy may improve the chance of sustained drug-free remission in ACPA-positive patients with recent-onset RA.
Authors: H W van Steenbergen; J A B van Nies; A Ruyssen-Witrand; T W J Huizinga; Al Cantagrel; F Berenbaum; A H M van der Helm-van Mil Journal: Arthritis Res Ther Date: 2015-09-08 Impact factor: 5.156
Authors: Josef S Smolen; Ferdinand C Breedveld; Gerd R Burmester; Vivian Bykerk; Maxime Dougados; Paul Emery; Tore K Kvien; M Victoria Navarro-Compán; Susan Oliver; Monika Schoels; Marieke Scholte-Voshaar; Tanja Stamm; Michaela Stoffer; Tsutomu Takeuchi; Daniel Aletaha; Jose Louis Andreu; Martin Aringer; Martin Bergman; Neil Betteridge; Hans Bijlsma; Harald Burkhardt; Mario Cardiel; Bernard Combe; Patrick Durez; Joao Eurico Fonseca; Alan Gibofsky; Juan J Gomez-Reino; Winfried Graninger; Pekka Hannonen; Boulos Haraoui; Marios Kouloumas; Robert Landewe; Emilio Martin-Mola; Peter Nash; Mikkel Ostergaard; Andrew Östör; Pam Richards; Tuulikki Sokka-Isler; Carter Thorne; Athanasios G Tzioufas; Ronald van Vollenhoven; Martinus de Wit; Desirée van der Heijde Journal: Ann Rheum Dis Date: 2015-05-12 Impact factor: 19.103
Authors: Filip Van den Bosch; Philip J Mease; Joachim Sieper; Dominique L Baeten; Yinglin Xia; Su Chen; Aileen L Pangan; In-Ho Song Journal: RMD Open Date: 2018-02-26
Authors: Josef S Smolen; Robert Landewé; Ferdinand C Breedveld; Maya Buch; Gerd Burmester; Maxime Dougados; Paul Emery; Cécile Gaujoux-Viala; Laure Gossec; Jackie Nam; Sofia Ramiro; Kevin Winthrop; Maarten de Wit; Daniel Aletaha; Neil Betteridge; Johannes W J Bijlsma; Maarten Boers; Frank Buttgereit; Bernard Combe; Maurizio Cutolo; Nemanja Damjanov; Johanna M W Hazes; Marios Kouloumas; Tore K Kvien; Xavier Mariette; Karel Pavelka; Piet L C M van Riel; Andrea Rubbert-Roth; Marieke Scholte-Voshaar; David L Scott; Tuulikki Sokka-Isler; John B Wong; Désirée van der Heijde Journal: Ann Rheum Dis Date: 2013-10-25 Impact factor: 19.103
Authors: Paulina Chalan; Johan Bijzet; Anke van den Berg; Joost Kluiver; Bart-Jan Kroesen; Annemieke M H Boots; Elisabeth Brouwer Journal: Sci Rep Date: 2016-05-18 Impact factor: 4.379
Authors: Emma C de Moel; Veerle F A M Derksen; Gerrie Stoeken; Leendert A Trouw; Holger Bang; Robbert J Goekoop; Irene Speyer; Tom W J Huizinga; Cornelia F Allaart; René E M Toes; Diane van der Woude Journal: Arthritis Res Ther Date: 2018-02-26 Impact factor: 5.156