Aiming for SDAI remission versus low disease activity at 1 year after inclusion in ESPOIR cohort is associated with better 3-year structural outcomes

作者：Ruyssen Witrand Adeline^*; Guernec Gregory; Nigon Delphine; Tobon Gabriel; Jamard Benedicte; Rat Anne Christine; Vittecoq Olivier; Cantagrel Alain; Constantin Arnaud

来源：Annals of the Rheumatic Diseases, 2015, 74(9): 1676-1683.

DOI：10.1136/annrheumdis-2013-204906

Objectives Using data for patients with early rheumatoid arthritis (RA) from the ESPOIR cohort, we aimed to evaluate the impact of remission versus low disease activity (LDA) by the Simple Disease Activity Index (SDAI) at 1 year on 3-year structural damage assessed by the modified Sharp-van der Heijde total score (mTSS) and functional impairment assessed by the Health Assessment Questionnaire Disability Index (HAQ-DI).
Methods We included 625 patients from the ESPOIR cohort who fulfilled the 2010 American College of Rheumatology/European League Against Rheumatism criteria for RA at baseline and had an SDAI score at 1 year. mTSS and HAQ-DI scores were compared at 3 years for patients with SDAI remission or LDA status at 1 year. A linear mixed model was used to assess the independent effect of SDAI status at 1 year on mTSS and HAQ-DI at 3 years.
Results Of the 625 patients included (mean (SD) age 48.5 (12.1) years; 491 (78.6%) were women), 121 (19.4%) were in SDAI remission and 223 (35.7%) in LDA at 1 year. The mean (SD) mTSS and HAQ-DI score at 3 years was 9.6 (9.2) and 0.23 (0.42), respectively, for patients in remission at 1 year and 15.8 (16.1) and 0.43 (0.52), respectively, for patients with LDA (both p< 0.05). Multivariate analysis revealed an association of remission rather than LDA status at 1 year and reduced mTSS score (p= 0.005) but not HAQ-DI score (p= 0.4) at 3 years.
Conclusions Aiming for SDAI remission rather than LDA at 1 year leads to better radiographic outcomes at 3 years in early RA patients.

• 出版日期2015-9