Bindee Kuriya1, Juan Xiong2, Gilles Boire2, Boulos Haraoui2, Carol Hitchon2, Janet Pope2, John Carter Thorne2, Diane Tin2, Edward C Keystone2, Vivian Bykerk2. 1. From the Rheumatology Department, Mount Sinai Hospital, University of Toronto, Toronto, Ontario; Université de Sherbrooke, Sherbrooke; Rheumatic Disease Unit, Institut de Rhumatologie, Montreal, Quebec; Arthritis Centre, University of Manitoba, Winnipeg, Manitoba; Rheumatology Department, St. Joseph's Health Care, Western University, London; Southlake Regional Health Centre, Newmarket, Ontario, Canada; Hospital for Special Surgery, Cornell University, New York, New York, USA.B. Kuriya, MD, MS, FRCPC; J. Xiong, MSc, PhD, Rheumatology Department, Mount Sinai Hospital, University of Toronto; G. Boire, MD, MSc, FRCPC, Université de Sherbrooke; B. Haraoui, MD, FRCPC, Rheumatic Disease Unit, Institut de Rhumatologie; C. Hitchon, MD, MSc, FRCPC, Arthritis Centre, University of Manitoba; J. Pope, MD, MPH, FRCPC, Rheumatology Department, St. Joseph's Health Care, Western University; J.C. Thorne, MD, FRCP, FACP; D. Tin, BSc PHm, RPh, CDE, CGP, Southlake Regional Health Centre; E.C. Keystone, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto; V. Bykerk, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto, and Hospital for Special Surgery, Cornell University. bkuriya@mtsinai.on.ca. 2. From the Rheumatology Department, Mount Sinai Hospital, University of Toronto, Toronto, Ontario; Université de Sherbrooke, Sherbrooke; Rheumatic Disease Unit, Institut de Rhumatologie, Montreal, Quebec; Arthritis Centre, University of Manitoba, Winnipeg, Manitoba; Rheumatology Department, St. Joseph's Health Care, Western University, London; Southlake Regional Health Centre, Newmarket, Ontario, Canada; Hospital for Special Surgery, Cornell University, New York, New York, USA.B. Kuriya, MD, MS, FRCPC; J. Xiong, MSc, PhD, Rheumatology Department, Mount Sinai Hospital, University of Toronto; G. Boire, MD, MSc, FRCPC, Université de Sherbrooke; B. Haraoui, MD, FRCPC, Rheumatic Disease Unit, Institut de Rhumatologie; C. Hitchon, MD, MSc, FRCPC, Arthritis Centre, University of Manitoba; J. Pope, MD, MPH, FRCPC, Rheumatology Department, St. Joseph's Health Care, Western University; J.C. Thorne, MD, FRCP, FACP; D. Tin, BSc PHm, RPh, CDE, CGP, Southlake Regional Health Centre; E.C. Keystone, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto; V. Bykerk, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto, and Hospital for Special Surgery, Cornell University.
Abstract
OBJECTIVE: To evaluate the prevalence and predictive factors of sustained remission in an early rheumatoid arthritis (ERA) population. Predictive factors of sustained remission in ERA are unknown. We hypothesized that a short time to remission is an important predictor of sustained clinical remission. METHODS: Patients in the Canadian Early Arthritis Cohort were included. Remission was defined by Boolean-based American College of Rheumatology/European League Against Rheumatism clinical trial and clinical practice definitions and Simplified Disease Activity Index (SDAI). Logistic regression analysis identified predictors of sustained remission and influence of time to remission. RESULTS: Of 1840 patients, 633 (34%) achieved clinical trial remission, 759 (41%) clinical practice remission, and 727 (39%) SDAI remission. Over half of those meeting remission criteria achieved sustained remission based on clinical trial (55%), clinical practice (60%), and/or SDAI (58%). Corticosteroid use and lack of initial disease-modifying antirheumatic drug (DMARD) were associated with decreased probability of sustained remission, while initial combination DMARD increased this probability. Female sex, greater pain, and longer time to first remission made sustained remission less likely. CONCLUSION: Female sex, greater pain, and lack of initial DMARD therapy reduced the probability of sustained remission. A shorter time to remission is related to sustainability and supports striving for early remission.
OBJECTIVE: To evaluate the prevalence and predictive factors of sustained remission in an early rheumatoid arthritis (ERA) population. Predictive factors of sustained remission in ERA are unknown. We hypothesized that a short time to remission is an important predictor of sustained clinical remission. METHODS:Patients in the Canadian Early Arthritis Cohort were included. Remission was defined by Boolean-based American College of Rheumatology/European League Against Rheumatism clinical trial and clinical practice definitions and Simplified Disease Activity Index (SDAI). Logistic regression analysis identified predictors of sustained remission and influence of time to remission. RESULTS: Of 1840 patients, 633 (34%) achieved clinical trial remission, 759 (41%) clinical practice remission, and 727 (39%) SDAI remission. Over half of those meeting remission criteria achieved sustained remission based on clinical trial (55%), clinical practice (60%), and/or SDAI (58%). Corticosteroid use and lack of initial disease-modifying antirheumatic drug (DMARD) were associated with decreased probability of sustained remission, while initial combination DMARD increased this probability. Female sex, greater pain, and longer time to first remission made sustained remission less likely. CONCLUSION: Female sex, greater pain, and lack of initial DMARD therapy reduced the probability of sustained remission. A shorter time to remission is related to sustainability and supports striving for early remission.
Authors: Rocio V Gamboa-Cárdenas; Manuel F Ugarte-Gil; Massardo Loreto; Mónica P Sacnun; Verónica Saurit; Mario H Cardiel; Enrique R Soriano; Cecilia Pisoni; Claudio M Galarza-Maldonado; Carlos Rios; Sebastião C Radominski; Geraldo da R Castelar-Pinheiro; Washington Alves Bianchi; Simone Appenzeller; Inés Guimarães da Silveira; Cristiano A de Freitas Zerbini; Carlo V Caballero-Uribe; Adriana Rojas-Villarraga; Marlene Guibert-Toledano; Francisco Ballesteros; Rubén Montufar; Janitzia Vázquez-Mellado; Jorge Esquivel-Valerio; Ignacio García De La Torre; Leonor A Barile-Fabris; Fedra Irazoque Palezuelos; Lilia Andrade-Ortega; Pablo Monge; Raquel Teijeiro; Ángel F Achurra-Castillo; María H Esteva Spinetti; Graciela S Alarcón; Bernardo A Pons-Estel Journal: Clin Rheumatol Date: 2019-06-03 Impact factor: 2.980
Authors: A Lauter; K Triantafyllias; R Leiß; C Amberger; J Engels; M Hesse; M Jendro; J Gilly; M-L Stadelmann; W Ziese; D Wollschläger; M Dreher; B Pfeiff; J Weinmann-Menke; T Panholzer; A Schwarting Journal: Z Rheumatol Date: 2019-09 Impact factor: 1.372
Authors: Peter M Ten Klooster; Martijn A H Oude Voshaar; Walid Fakhouri; Inmaculada de la Torre; Claudia Nicolay; Mart A F J van de Laar Journal: Clin Rheumatol Date: 2019-06-03 Impact factor: 2.980
Authors: Vivian P Bykerk; Gerd R Burmester; Bernard G Combe; Daniel E Furst; Tom W J Huizinga; Harris A Ahmad; Paul Emery Journal: Rheumatol Int Date: 2018-10-20 Impact factor: 2.631