Greater likelihood of remission in rheumatoid arthritis patients treated earlier in the disease course: results from the Consortium of Rheumatology Researchers of North America registry
Meyers Primary Care Institute; Department of Medicine, Division of Rheumatology; Department of Medicine, Division of Preventive and Behavorial Medicine
Adult; Aged; Antirheumatic Agents; Arthritis, Rheumatoid; Cohort Studies; Female; Humans; Male; Middle Aged; North America; Prospective Studies; *Registries; Remission Induction; Rheumatology; Time Factors; Tumor Necrosis Factor-alpha
Health Services Research | Musculoskeletal Diseases | Primary Care
OBJECTIVE: To examine whether disease duration is an independent predictor of achieving remission in rheumatoid arthritis (RA) patients initiating therapy.
METHODS: RA patients in the Consortium of Rheumatology Researchers of North America registry newly prescribed a nonbiologic disease-modifying antirheumatic drug (DMARD) or anti--tumor necrosis factor (anti-TNF) with at least one followup visit were identified.
RESULTS: Among the 1,646 nonbiologic DMARD initiators, CDAI remission occurred in 21.3% of those with ≤5 years of disease duration, 19.6% with 6-10 years, and 13.5% with greater than or equal to 11 years (P < 0.001); sustained remission occurred in 10.2%, 8.8%, and 2.5%, respectively (P < 0.001). Results were similar among the 3,179 anti-TNF initiators (CDAI remission in 22.3%, 17.7%, and 12.8%, respectively [P < 0.001]; CDAI sustained remission in 9.7%, 9.5%, and 4.2%, respectively [P < 0.001]). DAS28 results were similar in both groups. In adjusted analyses, an increase of disease duration by 5 years was associated with a reduced likelihood of CDAI remission in nonbiologic DMARD (odds ratio [OR] 0.91, 95% confidence interval [95% CI] 0.83-0.99) and anti-TNF initiators (OR 0.88, 95% CI 0.83-0.94). A similar result was seen for sustained remission using the CDAI (nonbiologic DMARD: OR 0.61, 95% CI 0.48-0.76; anti-TNF: OR 0.85, 95% CI 0.75-0.97).
CONCLUSION: Earlier treatment was associated with a greater likelihood of remission.
DOI of Published Version
Arthritis Care Res (Hoboken). 2011 Jun;63(6):856-64. doi: 10.1002/acr.20452. Link to article on publisher's site
Arthritis care and research
Furst DE, Pangan AL, Harrold LR, Chang H, Reed GW, Kremer J, Greenberg JD. (2011). Greater likelihood of remission in rheumatoid arthritis patients treated earlier in the disease course: results from the Consortium of Rheumatology Researchers of North America registry. Meyers Primary Care Institute Publications. https://doi.org/10.1002/acr.20452. Retrieved from https://escholarship.umassmed.edu/meyers_pp/512