RT Journal Article
SR Electronic
T1 Continual Maintenance of Remission Defined by the ACR/EULAR Criteria in Daily Practice Leads to Better Functional Outcomes in Patients with Rheumatoid Arthritis
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.160395
DO 10.3899/jrheum.160395
A1 Kumi Shidara
A1 Ayako Nakajima
A1 Eisuke Inoue
A1 Daisuke Hoshi
A1 Naoki Sugimoto
A1 Yohei Seto
A1 Eiichi Tanaka
A1 Shigeki Momohara
A1 Atsuo Taniguchi
A1 Hisashi Yamanaka
YR 2016
UL http://www.jrheum.org/content/early/2016/11/24/jrheum.160395.abstract
AB Objective To evaluate longterm functional outcomes in rheumatoid arthritis (RA) based on the number of times that the American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) or the 28-joint Disease Activity Score (DAS28) remission criteria were fulfilled. Methods Patients with RA who participated in all 6 data collections in an observational cohort from 2008 to 2010 and who fulfilled the DAS28 remission criteria at baseline were studied. Patients were classified by the number of times they fulfilled the ACR/EULAR [Boolean trial, Boolean practice, Simplified Disease Activity Index (SDAI), or Clinical Disease Activity Index (CDAI)] or DAS28 remission criteria at each collection. The OR for the Japanese version of the Health Assessment Questionnaire (J-HAQ) progression, based on the number of times each set of remission criteria was fulfilled, were calculated by logistic regression. Results A total of 915 patients were studied. The OR (95% CI) for J-HAQ progression were 0.54 (0.33–0.87), 0.55 (0.33–0.92), 0.48 (0.28–0.82), 0.29 (0.16–0.51), 0.24 (0.13–0.47), and 0.07 (0.03–0.15) for those fulfilling the Boolean trial remission from 1 to 6 times. This tendency was also observed for the other 4 criteria. The OR (95% CI) for J-HAQ progression in patients who achieved remission at all 6 data collections were 0.07 (0.03–0.14) for the Boolean practice, 0.10 (0.05–0.20) for the SDAI, and 0.07 (0.04–0.15) for the CDAI, whereas 0.15 (0.08-0.29) for the DAS28. Conclusion Continual fulfillment of any remission criteria was strongly effective in preventing patients from progression of functional disability; however, the ACR/EULAR criteria appear to be preferable.