Remission of rheumatoid arthritis and potential determinants: a national multi-center cross-sectional survey

Abstract

The aim of this study is to investigate the remission rate of rheumatoid arthritis (RA) in China and identify its potential determinants. A multi-center cross-sectional study was conducted from July 2009 to January 2012. Data were collected by face-to-face interviews of the rheumatology outpatients in 28 tertiary hospitals in China. The remission rates were calculated in 486 RA patients according to different definitions of remission: the Disease Activity Score in 28 joints (DAS28), the Simplified Disease Activity Index (SDAI), the Clinical Disease Activity Index (CDAI), and the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) Boolean definition. Potential determinants of RA remission were assessed by univariate and multivariate analyses. The remission rates of RA from this multi-center cohort were 8.6% (DAS28), 8.4% (SDAI), 8.2% (CDAI), and 6.8% (Boolean), respectively. Favorable factors associated with remission were: low Health Assessment Questionnaire (HAQ) score, absence of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP), and treatment of methotrexate (MTX) and hydroxychloroquine (HCQ). Younger age was also predictive for the DAS28 and the Boolean remission. Multivariate analyses revealed a low HAQ score, the absence of anti-CCP, and the treatment with HCQ as independent determinants of remission. The clinical remission rate of RA patients was low in China. A low HAQ score, the absence of anti-CCP, and HCQ were significant independent determinants for RA remission.

What Is the Relationship Between Morning Symptoms and Measures of Disease Activity in Patients With Rheumatoid Arthritis?

“…Our findings support the view that a DAS28 score below 2.6 is not remission but may more accurately be termed “minimal disease activity.” Note that the preliminary definition for minimal disease activity in RA, developed in 2005 , used a slightly different but equivalent cutoff of 2.85 to avoid confusion with the existing “remission” cutoff; however, with the publication of the ACR/EULAR remission criteria, this alternative cutoff is no longer necessary or useful. Our findings are consistent with other studies showing a lower remission rate when patient assessments are included in the definition . It is unclear whether increasing treatment in an attempt to achieve this stringent definition of remission would improve patient outcomes or result in overtreatment.…”

Salvianolic Acid B Suppresses Inflammatory Mediator Levels by Downregulating NF-κB in a Rat Model of Rheumatoid Arthritis

“…Moreover, RA reduces the quality of life due to severe pain, deformity, and disability, as well as its strong association with cardiovascular and cerebrovascular diseases. Thus, RA imposes an enormous social and economic burden in China [ 4 ].…”

Efficacy of Combination Therapy of Methotrexate With Hydroxychloroquine or Sulfasalazine in Rheumatoid Arthritis Patients in Kumaon Region: A Comparative Study

“…25 Another Asian multicenter cross-sectional study gave remission rates of RA, which were 8.6% (DAS28 ≤2.6) when treated with Methotrexate and Hydroxychloroquine. 26 The present study has its limitations, as RA is a chronic disease, so shorter duration of study 6 months might have concealed some findings. Patients were allowed to take concomitant medication, which might have affected the efficacy of the study drugs to some extent.…”