S Chandrashekara1, Vineeta Shobha2, B G Dharmanand3, Ramesh Jois4, Sharath Kumar5, Kurugodu M Mahendranath6, Vikram Haridas7, Shiva Prasad8, Yogesh Singh9, Manisha A Daware10, Anupama Swamy11, R Subramanian12, Srirama A Somashekar13, Arun M Shanthappa14, K R Anupama15. 1. ChanRe Rheumatology and Immunology Center, Bangalore, India. 2. St. John's Medical College Hospital, Bangalore, India. 3. Sakra Hospital, Bangalore, India. 4. Kanva Diagnostics Center, Bangalore, India. 5. Columbia Asia Hospital, Bangalore, India. 6. Samarpan Health Centre, Bangalore, India. 7. Arthritis Superspeciality Center, Hubli, India. 8. Vikram Hospital Pvt. Ltd, Mysore, India. 9. Manipal Hospital, Mysore, Karnataka, India. 10. Narayana Health City, Mysore, Karnataka, India. 11. Anurag Clinic, Mysore, Karnataka, India. 12. JSS Medical College, Mysore, Karnataka, India. 13. Bangalore Rheumatology Center, Bangalore, India. 14. Arushi Rheumatology Center, Tumkur, India. 15. ChanRe Rheumatology and Immunology Center, Basaweswaranagar, Bangalore, India.
Abstract
AIM: To study the prevalence of remission in rheumatoid arthritis (RA) patients and the influence of different factors like literacy, socioeconomic status, presence of comorbidity and treatment strategy in achieving remission. METHODS: The study involved 1990 RA patients who were recruited for the Karnataka Rheumatoid arthritis comorbidity (KRAC) study. Based on the factors evaluated, the study participants were classified as follows: age, < 30 years, 30-39 years, 40-49 years, 50-59 years and ≥ 60 years; educational status, illiterate/no formal education, high school or less, graduate, post-graduate and doctorate; family income (₹ per annum), < 50 000, 50-100 000, 100-500 000, and > 500 000; duration of illness prior (DOIP): ≤ 6 months, 6-24 months, 24-120 months and > 120 months. Joint counts were performed by a rheumatologist or trained joint assessor. To assess the treatment outcome, the disease activity score was calculated using the Disease activity Score of 28 joints - erythrocyte sedimentation rate (DAS 28-3 ESR). RESULTS: As per the DAS 28-3 ESR score, around 20% (n = 397) of the study subjects achieved remission. The corresponding mean ± SD of DAS 28-3 ESR noted for remission and non-remission groups were 2.13 ± 0.42 and 4.32 ± 1.28. The majority of the patients were treated with double disease-modifying anti-rheumatic drugs (DMARDs) (60.7%). The likelihood of remission was found to be more in patients who reported DOIP ≤ 6 months. Furthermore, the chances of remission reduced with increase in patient's age and the highest remission rate was noted for 30-39 years age group (59%), followed by 40-49 years (35.4%) and 50-59 years (19.7%). CONCLUSION: The prevalence of remission noted was around 20%. Early treatment, escalating dose of DMARDs, and patient counseling are important contributing factors for attaining remission.
AIM: To study the prevalence of remission in rheumatoid arthritis (RA) patients and the influence of different factors like literacy, socioeconomic status, presence of comorbidity and treatment strategy in achieving remission. METHODS: The study involved 1990 RApatients who were recruited for the Karnataka Rheumatoid arthritis comorbidity (KRAC) study. Based on the factors evaluated, the study participants were classified as follows: age, < 30 years, 30-39 years, 40-49 years, 50-59 years and ≥ 60 years; educational status, illiterate/no formal education, high school or less, graduate, post-graduate and doctorate; family income (₹ per annum), < 50 000, 50-100 000, 100-500 000, and > 500 000; duration of illness prior (DOIP): ≤ 6 months, 6-24 months, 24-120 months and > 120 months. Joint counts were performed by a rheumatologist or trained joint assessor. To assess the treatment outcome, the disease activity score was calculated using the Disease activity Score of 28 joints - erythrocyte sedimentation rate (DAS 28-3 ESR). RESULTS: As per the DAS 28-3 ESR score, around 20% (n = 397) of the study subjects achieved remission. The corresponding mean ± SD of DAS 28-3 ESR noted for remission and non-remission groups were 2.13 ± 0.42 and 4.32 ± 1.28. The majority of the patients were treated with double disease-modifying anti-rheumatic drugs (DMARDs) (60.7%). The likelihood of remission was found to be more in patients who reported DOIP ≤ 6 months. Furthermore, the chances of remission reduced with increase in patient's age and the highest remission rate was noted for 30-39 years age group (59%), followed by 40-49 years (35.4%) and 50-59 years (19.7%). CONCLUSION: The prevalence of remission noted was around 20%. Early treatment, escalating dose of DMARDs, and patient counseling are important contributing factors for attaining remission.
Authors: Dionicio A Galarza-Delgado; Jose R Azpiri-Lopez; Iris J Colunga-Pedraza; Jesus A Cárdenas-de la Garza; Raymundo Vera-Pineda; Martín Wah-Suárez; Rosa I Arvizu-Rivera; Adrian Martínez-Moreno; Ray E Ramos-Cázares; Francisco J Torres-Quintanilla; Aldo Valdovinos-Bañuelos; Jorge Antonio Esquivel-Valerio; Mario A Garza-Elizondo Journal: Rheumatol Int Date: 2017-07-05 Impact factor: 2.631
Authors: Mrinalini Dey; Amanda Busby; Helen Elwell; Heidi Lempp; Arthur Pratt; Adam Young; John Isaacs; Elena Nikiphorou Journal: RMD Open Date: 2022-04