Attaining remission in rheumatoid arthritis (RA) is highly specific for attaining low disability and normal health-related quality of life (HRQOL), although many patients with more active disease also have good function and HRQOL, a recent study found. Furthermore, attaining a Disease Activity Score 28-erythrocyte sedimentation rate (DAS28-ESR) ≤3.2 has a better balance of specificity and sensitivity for attaining these outcomes, with the benefit of being more readily achievable. Researchers studied 571 patients in 2 clinical trials, and 1,693 patients in a 10-year routine care cohort. They found:
- Point remission and remission/low disease activity (LDA) were common (achieved by 35-58% and 49-74% of patients, respectively), but were rarely sustained (sustained remission and remission/LDA achieved by 5-9% and 9-16% of patients, respectively).
- Following attaining remission, DAS28-ESR levels varied substantially.
- Despite this, of those patients attaining point remission, the majority (53-61%) were in remission at study end-points.
- While remission was highly specific at identifying patients with low disability (85-91%), it lacked sensitivity (51-57%); similar findings were seen for normal HRQOL (specificity 78-86%; sensitivity 52-59%).
Scott IC, Fowzia I, Panayi G, et al. The frequency of remission and low disease activity in patients with rheumatoid arthritis, and their ability to identify people with low disability and normal quality of life. [Published online ahead of print December 28, 2018]. Semin Arthritis Rheum. doi:10.1016/j.semarthrit.2018.12.006.
This Week's Must Reads
Long-term Opioid Use with Severe OA by Geography, Arthritis Rheumatol; ePub 2019 Jan 28; Desai, et al
Family History of Psoriasis and Psoriatic Disease, Arthritis Care Res; ePub 2019 Jan 25; Solmaz, et al
Remission/Low Disease Activity Protective in SLE , Lupus; ePub 2019 Jan 24; Alarcón, Ugarte-Gil, et al
Dietary Niacin Linked with Incident Hip Fracture, J Bone Miner Res; ePub 2019 Jan 19; Carbone, et al
Must Reads in Rheumatoid Arthritis
TNF inhibitor prices rose despite increased drug class competition, San-Juan-Rodriguez A et al. JAMA Intern Med. 2019 Feb 18. doi: 10.1001/jamainternmed.2018.7656
Examining Brain Correlates of Clinical Pain in RA, Arthritis Care Res; 2019 Feb; Lee, Fine, et al
Obesity/Weight Loss Linked to Mortality Risk in RA, Clin Exp Rheumatol; ePub 2019 Jan 18; Baker, et al
Study Does Not Back MRI-Guided Treatment Strategy, JAMA; ePub 2019 Feb 5; Møller-Bisgaard, et al