Rapid remission during the first year in early active rheumatoid arthritis is associated with better 5 years structural damage outcomes
(2018) Annual European Congress of Rheumatology (EULAR) — Location: (Netherlands) Amsterdam (13.June.2018)
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- BACKGROUND Remission is arguably the best and ultimate therapeutic goal in early rheumatoid arthritis (ERA). ERA patients who reach rapid and sustained remission are likely to retain good radiographic outcomes. OBJECTIVES The aim of this study was to evaluate the radiographic progression and the newly pathological joints in a Belgian ERA cohort during a 5 to 15 years follow-up and to correlate the Sharp score index with different indices of clinical remission observed during the first year. METHODS This was a retrospective analysis of mean (95% CI) change from baseline (BL) to 5 years Sharp/Van der Heijde (SVdH) scoring according to DAS28, SDAI, CDAI and ACR/EULAR Boolean remission scores for patients at Month 3, 6 and 12. Newly pathological joint defined by a SVdH score of 0 at baseline and a score greater than or equal to 1 at follow up were analysed as a secondary objective. 133 ERA patients naïve to DMARDs therapies were analysed (100 women and 33 men) with a mean age ±SD (49.9±13.3), mean DAS 28-CRP (4.89±1.3), mean HAQ (1.25±0.67), mean SDAI (28.4±15.5), mean CDAI (25.8±14.8) and mean SVdH (6±14). Differences were statistically tested using t tests. results ERA patients were divided in 2 groups: ”Xrays Stable” if the delta of SVdH score was <10 (n=90) or ”Xrays Progressive” if the delta of SVdH score was >10 (n=43). As expected, presence of ACPA and baseline erosion were significantly higher in the Xrays progressive group. No significant baseline characteristics differences were observed for DAS28-CRP, CDAI, SDAI, HAQ. smoking status, swollen joint count or CRP.% of patients reaching DAS 28CRP, SDAI, CDAI and Boolean remission rates observed at 6 months were statistically significant different between groups (fig). There was no significant difference in clinical responses between subgroups of patients who developed new pathological joints and those who did not. CONCLUSIONS These results demonstrate that remission is an important therapeutic goal to protect joint damage in ERA. All remission criteria were able to predict the radiological prevention. The identification of a new pathologic joint is not associated with lack of response.
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Legrand, J., Kirchgesner, T., Sokolova, T., Vande Berg, B., & Durez, P. (2018). Rapid remission during the first year in early active rheumatoid arthritis is associated with better 5 years structural damage outcomes. Published. Annual European Congress of Rheumatology (EULAR), (Netherlands) Amsterdam. https://doi.org/10.1136/annrheumdis-2018-eular.4940