Adeline Ruyssen-Witrand1, Gregory Guernec2, Delphine Nigon3, Gabriel Tobon4, Bénédicte Jamard3, Anne-Christine Rat5, Olivier Vittecoq6, Alain Cantagrel7, Arnaud Constantin1. 1. UMR 1027, INSERM, Toulouse, France UMR 1027, University Paul Sabatier Toulouse III, Toulouse, France Rheumatology Center, Purpan Hospital, Toulouse, France. 2. UMR 1027, INSERM, Toulouse, France UMR 1027, University Paul Sabatier Toulouse III, Toulouse, France. 3. Rheumatology Center, Purpan Hospital, Toulouse, France. 4. Rheumatology Department, Cavale Blanche Hospital, Brest, France. 5. Rheumatology Department, CHU Bravois, Vandoeuvre les Nancy, France. 6. Rheumatology Department, CHU de Rouen, Rouen, France. 7. Rheumatology Center, Purpan Hospital, Toulouse, France JE2510, University Paul Sabatier Toulouse III, Toulouse, France.
Abstract
OBJECTIVES: Using data for patients with early rheumatoid arthritis (RA) from the ESPOIR cohort, we aimed to evaluate the impact of remission versus low disease activity (LDA) by the Simple Disease Activity Index (SDAI) at 1 year on 3-year structural damage assessed by the modified Sharp-van der Heijde total score (mTSS) and functional impairment assessed by the Health Assessment Questionnaire Disability Index (HAQ-DI). METHODS: We included 625 patients from the ESPOIR cohort who fulfilled the 2010 American College of Rheumatology/European League Against Rheumatism criteria for RA at baseline and had an SDAI score at 1 year. mTSS and HAQ-DI scores were compared at 3 years for patients with SDAI remission or LDA status at 1 year. A linear mixed model was used to assess the independent effect of SDAI status at 1 year on mTSS and HAQ-DI at 3 years. RESULTS: Of the 625 patients included (mean (SD) age 48.5 (12.1) years; 491 (78.6%) were women), 121 (19.4%) were in SDAI remission and 223 (35.7%) in LDA at 1 year. The mean (SD) mTSS and HAQ-DI score at 3 years was 9.6 (9.2) and 0.23 (0.42), respectively, for patients in remission at 1 year and 15.8 (16.1) and 0.43 (0.52), respectively, for patients with LDA (both p<0.05). Multivariate analysis revealed an association of remission rather than LDA status at 1 year and reduced mTSS score (p=0.005) but not HAQ-DI score (p=0.4) at 3 years. CONCLUSIONS: Aiming for SDAI remission rather than LDA at 1 year leads to better radiographic outcomes at 3 years in early RA patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
OBJECTIVES: Using data for patients with early rheumatoid arthritis (RA) from the ESPOIR cohort, we aimed to evaluate the impact of remission versus low disease activity (LDA) by the Simple Disease Activity Index (SDAI) at 1 year on 3-year structural damage assessed by the modified Sharp-van der Heijde total score (mTSS) and functional impairment assessed by the Health Assessment Questionnaire Disability Index (HAQ-DI). METHODS: We included 625 patients from the ESPOIR cohort who fulfilled the 2010 American College of Rheumatology/European League Against Rheumatism criteria for RA at baseline and had an SDAI score at 1 year. mTSS and HAQ-DI scores were compared at 3 years for patients with SDAI remission or LDA status at 1 year. A linear mixed model was used to assess the independent effect of SDAI status at 1 year on mTSS and HAQ-DI at 3 years. RESULTS: Of the 625 patients included (mean (SD) age 48.5 (12.1) years; 491 (78.6%) were women), 121 (19.4%) were in SDAI remission and 223 (35.7%) in LDA at 1 year. The mean (SD) mTSS and HAQ-DI score at 3 years was 9.6 (9.2) and 0.23 (0.42), respectively, for patients in remission at 1 year and 15.8 (16.1) and 0.43 (0.52), respectively, for patients with LDA (both p<0.05). Multivariate analysis revealed an association of remission rather than LDA status at 1 year and reduced mTSS score (p=0.005) but not HAQ-DI score (p=0.4) at 3 years. CONCLUSIONS: Aiming for SDAI remission rather than LDA at 1 year leads to better radiographic outcomes at 3 years in early RApatients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: Sytske Anne Bergstra; Otto Olivas; Gülşah Akdemir; Naghmeh Riyazi; Gerard Collée; Johannes H L M van Groenendael; Robert B M Landewé; Cornelia F Allaart Journal: Arthritis Res Ther Date: 2017-09-30 Impact factor: 5.156