Contributing factors of clinical outcomes at 1 year post-diagnosis in early rheumatoid arthritis patients with tightly controlled disease activity in clinical practice: a retrospective study

Abstract

Objectives

To determine whether specific parameters contribute to clinical outcomes at 1 year post-diagnosis in early rheumatoid arthritis (RA) patients under the ‘treat-to-target’ strategy in clinical practice.

Methods

We retrospectively analyzed 125 RA patients selected according to the following criteria; the patients’ symptom duration was ≤6 months, and none had experience with DMARDs. We evaluated the patients’ clinical disease activity at baseline and 1 year of treatment and the musculoskeletal ultrasound (MSUS)-detected synovitis activity at baseline. We performed an analysis to identify parameters that contribute to SDAI remission and the use of biologic/targeted synthetic (b/ts) DMARDs at 1 year post-diagnosis.

Results

Forty-seven patients received b/tsDMARDs therapy, and 58 patients achieved SDAI remission at 1 year post-diagnosis. Rheumatoid factor positivity, low patient’s/evaluator’s global assessment at baseline, and methotrexate use at 1 year post-diagnosis were associated with SDAI remission. The baseline clinical disease activity and MSUS scores were not associated with SDAI remission. Anti-cyclic citrullinated peptide antibody positivity/high titer and high swollen joint counts or the presence of severe synovial hypertrophy at baseline were associated with the use of b/tsDMARDs therapy.

Conclusion

The value of the expected poor-prognosis factors may be diminished by intensive therapy within the ‘windows of opportunity’.

Keywords:

• Rheumatoid arthritis
• musculoskeletal ultrasound
• SDAI remission
• biologic/targeted synthetic DMARD
• prognostic factor

Conflicts of interest

None.

Ethics approval

The study was approved by the Institutional Review Board of Nagasaki University (Approval No. 10062546).

Additional information

Funding

No funding was received for this study.