Sundlisæter NP, et al. - Researchers studied the prognostic factors for achievement of sustained remission in early rheumatoid arthritis (RA) patients receiving semi-personalized tight controlled treatment. They also evaluated the consistency of potential predictors across definitions of sustained remission. At baseline, the chance of reaching sustained remission across all definitions was reduced by a higher tender joint score. In early RA, sustained remission as an achievable goal especially when initiating DMARDs within 3 months symptom duration was supported in the findings.

Methods

• Experts treated the DMARD-naïve early RA patients with symptom duration <2 years according to a pre-defined algorithm within the Aiming for Remission in rheumatoid arthritis: A randomised trial examining the benefit of ultrasound in a Clinical TIght Control regimen trial.
• Treatment adjustments based on established risk factors for a worse outcome were allowed by the algorithm.
• They used multivariate logistic regression in order to examine baseline predictors of achieving sustained DAS remission at 16–24 months, and to evaluate predictors of secondary remission outcomes (all sustained 16–24 months): ACR/EULAR Boolean, Simplified Disease Activity Index (SDAI), no swollen joints and a composite outcome of DAS remission, no swollen joints and no radiographic progression.

Results

• Findings suggested that out of 222 patients, 118 (53%) reached sustained DAS remission, while 53 (24%) reached sustained ACR/EULAR Boolean and 73 (33%) sustained SDAI remission.
• Findings suggested that more joint tenderness, assessed by Ritchie Articular Index, was a negative predictor of reaching sustained DAS remission (odds ratio (OR) = 0.90/U, 95% CI: 0.86, 0.94), sustained ACR/EULAR Boolean remission (OR = 0.92, 95% CI: 0.86, 0.98), sustained SDAI remission (OR = 0.94, 95% CI: 0.90, 1.00) as well as the two alternative definitions of sustained remission.
• As per data, at baseline sustained Boolean and SDAI remission waere predicted by short symptom duration .
• Across outcomes, other identified predictors were inconsistent.