Nikiphorou, E; Norton, SJ; Carpenter, L; Walsh, DA; Creamer, P; Dixey, J; Young, A; Kiely, PDW; for ERAS and ERAN
(2020)
Remission vs low disease activity: function, quality of life and structural outcomes in the Early Rheumatoid Arthritis Study and Network.
Rheumatology (Oxford), 59 (6).
pp. 1272-1280.
ISSN 1462-0332
https://doi.org/10.1093/rheumatology/kez461
SGUL Authors: Kiely, Patrick David Wolfenden
Abstract
OBJECTIVES: To examine associations between function, quality of life and structural outcomes in patients achieving remission vs low disease activity in early RA. METHODS: Demographic, clinical and radiographic variables were collected at baseline and then annually from the Early Rheumatoid Arthritis Study (ERAS) and Early Rheumatoid Arthritis Network (ERAN) inception cohorts in routine care from 1986 to 2012. Disease activity was categorized: mean DAS28 score between years 1 and 5: remission [mean remission DAS (mRDAS) <2.6] or low [mean low DAS (mLDAS) 2.6-3.2]; sustained low/remission DAS28 (sLDAS/sRDAS) at years 1 and 2; and sustained Boolean remission (sBR) at years 1 and 2. Changes in HAQ and Short Form 36 Health Survey Questionnaire [SF-36; physical (PCS) and mental (MCS) component score]) and total Sharp van der Heijde (SvdH) scores for each disease activity category were modelled using multi-level models. Covariates included year of onset, age, gender and DMARD use at first visit. RESULTS: Of 2701 patients, 562 (21%) were categorized mRDAS, 330 (12%) mLDAS, 279 (10%) sRDAS, 203 (7.5%) sLDAS and 93 (3%) sBR. Patients categorized as mRDAS had increasingly divergent improved HAQ, SF-36 PCS, MCS and total SvdH scores compared with mLDAS (P-values 0.001 to <0.0001, all time points). Patients categorized as sRDAS had better HAQ, SF-36 PCS and MCS scores (P-values 0.05 to <0.0001, all time points) and SvdH scores (P = 0.05, years 3-5) over sLDAS. sBR was associated with better HAQ, and SF-36 PCS and MCS scores over sLDAS (P-values 0.002 to <0.0001, all time points). CONCLUSION: These findings from routine care support ACR/EULAR guidelines that remission is a preferable goal over low disease activity in early RA.
Item Type: |
Article
|
Additional Information: |
© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Rheumatology.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
Keywords: |
damage, function, life quality, low disease activity, remission, rheumatoid arthritis, for ERAS and ERAN, rheumatoid arthritis, remission, low disease activity, life quality, function, damage, Arthritis & Rheumatology, 1103 Clinical Sciences, 1107 Immunology, 1117 Public Health and Health Services |
SGUL Research Institute / Research Centre: |
Academic Structure > Institute of Medical & Biomedical Education (IMBE) Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Clinical Education (INMECE ) |
Journal or Publication Title: |
Rheumatology (Oxford) |
ISSN: |
1462-0332 |
Language: |
eng |
Dates: |
Date | Event |
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1 June 2020 | Published | 3 October 2019 | Published Online | 7 September 2019 | Accepted |
|
Publisher License: |
Creative Commons: Attribution-Noncommercial 4.0 |
Projects: |
Project ID | Funder | Funder ID |
---|
Y0506 | Alzheimer's Research UK | UNSPECIFIED | Y0514 | Alzheimer's Research UK | UNSPECIFIED |
|
PubMed ID: |
31580448 |
Web of Science ID: |
WOS:000538792200014 |
![](http://static.pubmed.gov/portal/portal3rc.fcgi/2745237/img/27842) |
Go to PubMed abstract |
URI: |
https://openaccess.sgul.ac.uk/id/eprint/112281 |
Publisher's version: |
https://doi.org/10.1093/rheumatology/kez461 |
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