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.


Increasing Chance of Remission in Patients with Rheumatiod Arthritis.

Strangfeld1,  Anja, Eveslage3,  Maria, Aringer4,  Martin, Dockhorn5,  Rainer, Schneider6,  Matthias, Listing3,  Joachim, Zink2,  Angela

German Rheumatism Research Center, Berlin, Germany
German Rheumatism Research Center and Charité University Medicine Berlin
German Rheumatism Research Center, Berlin
Rheumatologist, Dresden, Germany
Rheumatologist, Weener, Weener, Germany
Scientific Advisory Board, Düsseldorf

Background:

During the last years treatment aims in patients with rheumatoid arthritis (RA) have changed. Nowadays, achieving remission is a major goal. We therefore analyzed if the proportion of patients who achieved remission in DAS28 after several years of treatment with biologic agents changed during the last years.

Methods:

The analysis was based on RA patients enrolled in the German biologics register RABBIT at start of an anti-TNF treatment. Remission rates (DAS28 < 2.6) after three years of follow-up were compared between patients enrolled from 2001 to 2003 (n = 841) and those recruited from 2004 to 2006 (n = 1,290). Logistic regression was applied to compare both groups after adjustment for prognostic factors.

Results:

Crude remission rates at 36 months were significantly higher in patients enrolled between 2004–2006 than in those enrolled between 2001–2003 (26% vs. 19%). Higher rates were observed especially in patients with highly active disease (DAS28 > 6) at baseline (19.7% vs. 12.4 % in remission). The increase could not be explained by differences in baseline status.

The short term treatment response (DAS28 after 6 months) was the most distinct predictor for being in remission after 3 years. Additionally, male patients, younger patients, patients with better functional capacity and patients with a low disease activity at baseline had a higher chance of remission. When adjusting for these factors by multiple logistic regression the beneficial effect for patients enrolled between 2004–2006 was associated with the activity of the RA 6 months after start of treatment (Table).Patients with an active disease 6 months after start of treatment had a higher chance of remission when they were enrolled in the later period (table). This was not due to more treatment changes in patients registered later (37% vs. 37% patients who started another biologic) but was possibly caused by more frequent use of novel biologics with different mechanisms of action (14% vs. 3%).

Table 1. Probability of remission after 3 years estimated by multiple logistic regression stratified by enrollment period and level of disease activity after 6 months of the initial treatment.

DAS28 after 6 monthsn2001–2003 remission (%)n2004–2006 remission (%)
<= 3.221740.342738.5
> 3.2 & <= 4.118019.630825.4
> 4.1 & <= 5.120011.027118.8
> 5.12443.628410.0
total84118.31,29025.0

Conclusion:

The availability of more treatment options accompanied with changes in treatment strategies increases the chance for RA patients to achieve remission.

To cite this abstract, please use the following information:
Strangfeld, Anja, Eveslage, Maria, Aringer, Martin, Dockhorn, Rainer, Schneider, Matthias, Listing, Joachim, et al; Increasing Chance of Remission in Patients with Rheumatiod Arthritis. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1111
DOI: 10.1002/art.28878

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