Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.
Low Rate of Rheumatoid Arthritis Remission in Real Life: Might Predictive Factors Explain?
Loppin2, Elodie, Garlantezec1, Ronan, Solau-Gervais2, Elisabeth
Remission constitutes the best achievable state in patients with rheumatoid arthritis (RA). Remission rates in usual clinical care are much more lower than the one in randomized clinical trials (1). The objective of the study was to define remission factors in "real life".
Remission has been assessed retrospectively for records of 364 patients with rheumatoid arthritis receiving usual care. These patients were out and in patients followed in an university hospital with at least one visit in year 2008. Disease activity was evaluated on records according to DAS 28 criteria. Remission was defined by a DAS28 < 2.6.Statistical analysis used Chi-2 and multivariate analysis with the software SAS9.
The evaluation of disease activity was available for 328 patients (90 %). Mean age of the patients was 63 years (+/-13,7) and mean duration of the disease was 13,6 (+/-10,7). Rheumatoid factor and anti-CCP was positive respectively in 79.3% and 73.8 %. Eighty five percent had an erosive disease. The rate of global remission was 28 %. Factors associated statistically with remission in multivariate analyse were (Ors 95% confidence intervals): male sex (0,2-0,8), younger age (0,2-0,9), rheumatoid factor-positive (1,26,5) and the absence of concomitant prednisolone treatment (0,3-0,9). Younger age and rheumatoid factor-positive represents more a population with a "higher therapeutic objective" and female sex and older age patients have more a difference in the evaluation of the disease, rather than true differences in RA activity. Moreover, the remission rate was significantly different according to the treatment: 15% without DMARDs or biotherapy, 24% with DMARDs and 47% with anti-TNF alpha treatment. As regards to the three anti-TNF alpha, the remission rate was the lowest for infliximab (18%), than etanercept (43%). Patients treated with adalimumab had the highest rate of remission with 64%. The difference was significant between infliximab and adalimumab (OR: 1.2101) and between infliximab and etanercept (OR: 1,130,15) but not between etanercept and adalimumab.
Male sex, younger age, rheumatoid factor-positive and corticoids free are associated with remission. Assessing remission in clinical practice is possible, and etanercept and adalimumab treatments are associated with higher rate of remission.
(1)Sokka, T, Hetland, ML, Makinen, H, Kautiainen, H, Horslev-Petersen, K & Luukkainen, RK, et al. Remission and rheumatoid arthritis: data on patients receiving usual care in twenty-four countries. Arthritis Rheum 2008;58(9):2642-51.
To cite this abstract, please use the following information:
Loppin, Elodie, Garlantezec, Ronan, Solau-Gervais, Elisabeth; Low Rate of Rheumatoid Arthritis Remission in Real Life: Might Predictive Factors Explain? [abstract]. Arthritis Rheum 2010;62 Suppl 10 :315