Kumi Shidara1,2,3, Ayako Nakajima4,5,6, Eisuke Inoue1,2,3, Daisuke Hoshi1,2,3, Naoki Sugimoto1,2,3, Yohei Seto1,2,3, Eiichi Tanaka1,2,3, Shigeki Momohara1,2,3, Atsuo Taniguchi1,2,3, Hisashi Yamanaka1,2,3. 1. From the Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan. 2. H. Yamanaka has received research grants from Astellas Pharma Inc. and Bristol-Myers-Squibb. 3. K.S. Shidara, MD, PhD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; A.N. Nakajima, MD, PhD, Associate Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.I. Inoue, PhD, Institute of Rheumatology, Tokyo Women's Medical University; D.H. Hoshi, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; N.S. Sugimoto, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; Y.S. Seto, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.T. Tanaka, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; S.M. Momohara, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; A.T. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H.Y. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University. 4. From the Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan. ayakonkj@twmu.ac.jp. 5. H. Yamanaka has received research grants from Astellas Pharma Inc. and Bristol-Myers-Squibb. ayakonkj@twmu.ac.jp. 6. K.S. Shidara, MD, PhD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; A.N. Nakajima, MD, PhD, Associate Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.I. Inoue, PhD, Institute of Rheumatology, Tokyo Women's Medical University; D.H. Hoshi, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; N.S. Sugimoto, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; Y.S. Seto, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.T. Tanaka, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; S.M. Momohara, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; A.T. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H.Y. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University. ayakonkj@twmu.ac.jp.
Abstract
OBJECTIVE: To evaluate longterm functional outcomes in rheumatoid arthritis (RA) based on the number of times that the American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) or the 28-joint Disease Activity Score (DAS28) remission criteria were fulfilled. METHODS: Patients with RA who participated in all 6 data collections in an observational cohort from 2008 to 2010 and who fulfilled the DAS28 remission criteria at baseline were studied. Patients were classified by the number of times they fulfilled the ACR/EULAR [Boolean trial, Boolean practice, Simplified Disease Activity Index (SDAI), or Clinical Disease Activity Index (CDAI)] or DAS28 remission criteria at each collection. The OR for the Japanese version of the Health Assessment Questionnaire (J-HAQ) progression, based on the number of times each set of remission criteria was fulfilled, were calculated by logistic regression. RESULTS: A total of 915 patients were studied. The OR (95% CI) for J-HAQ progression were 0.54 (0.33-0.87), 0.55 (0.33-0.92), 0.48 (0.28-0.82), 0.29 (0.16-0.51), 0.24 (0.13-0.47), and 0.07 (0.03-0.15) for those fulfilling the Boolean trial remission from 1 to 6 times. This tendency was also observed for the other 4 criteria. The OR (95% CI) for J-HAQ progression in patients who achieved remission at all 6 data collections were 0.07 (0.03-0.14) for the Boolean practice, 0.10 (0.05-0.20) for the SDAI, and 0.07 (0.04-0.15) for the CDAI, whereas 0.15 (0.08-0.29) for the DAS28. CONCLUSION: Continual fulfillment of any remission criteria was strongly effective in preventing patients from progression of functional disability; however, the ACR/EULAR criteria appear to be preferable.
OBJECTIVE: To evaluate longterm functional outcomes in rheumatoid arthritis (RA) based on the number of times that the American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) or the 28-joint Disease Activity Score (DAS28) remission criteria were fulfilled. METHODS:Patients with RA who participated in all 6 data collections in an observational cohort from 2008 to 2010 and who fulfilled the DAS28 remission criteria at baseline were studied. Patients were classified by the number of times they fulfilled the ACR/EULAR [Boolean trial, Boolean practice, Simplified Disease Activity Index (SDAI), or Clinical Disease Activity Index (CDAI)] or DAS28 remission criteria at each collection. The OR for the Japanese version of the Health Assessment Questionnaire (J-HAQ) progression, based on the number of times each set of remission criteria was fulfilled, were calculated by logistic regression. RESULTS: A total of 915 patients were studied. The OR (95% CI) for J-HAQ progression were 0.54 (0.33-0.87), 0.55 (0.33-0.92), 0.48 (0.28-0.82), 0.29 (0.16-0.51), 0.24 (0.13-0.47), and 0.07 (0.03-0.15) for those fulfilling the Boolean trial remission from 1 to 6 times. This tendency was also observed for the other 4 criteria. The OR (95% CI) for J-HAQ progression in patients who achieved remission at all 6 data collections were 0.07 (0.03-0.14) for the Boolean practice, 0.10 (0.05-0.20) for the SDAI, and 0.07 (0.04-0.15) for the CDAI, whereas 0.15 (0.08-0.29) for the DAS28. CONCLUSION: Continual fulfillment of any remission criteria was strongly effective in preventing patients from progression of functional disability; however, the ACR/EULAR criteria appear to be preferable.