ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 830

Five-Year Favourable Outcome of Patients with Early Rheumatoid Arthritis in the 2000s: Data From the Espoir Cohort

Bernard G. Combe1, Nathalie Rincheval2, Joelle Benessiano3, Francis Berenbaum4, Alain G. Cantagrel5, Jean-Pierre Daurès2, Maxime Dougados6, Patrice Fardellone7, Bruno Fautrel8, Rene-Marc Flipo9, Philippe M. Goupille10, Francis Guillemin11, Xavier X. Le Loet12, Isabelle Logeart13, Xavier Mariette14, Olivier Meyer15, Philippe Ravaud16, Alain Saraux17, Thierry Schaeverbeke18 and Jean Sibilia19, 1Rhumatologie, Hopital Lapeyronie, Montpellier, France, 2Institut Universitaire de Recherche Clinique, Montpellier, France, 3Rheumatology, Paris Unervisity Hospital BICHAT, Paris, France, 4Rheumatology, AP-HP, St Antoine Hospital, Paris, France, 5Dept of Rheumatology, Hopital Purpan, Toulouse CEDEX 9, France, 6Rheumatology B Department, Paris-Descartes University, APHP, Cochin Hospital, Paris, France, 7Service de Rhumatologie, C.H.U. D'Amiens, Amiens, France, 8Rheumatology / GRC08-EEMOIS, APHP-Pitie Salpetriere Hospital / UPMC, Paris, France, 9Rheumatology, Hopital R Salengro CHRU, Lille, France, 10Rheumatology, Hopital Trousseau, Tours, France, 11Ecole de Sante Publique, Faculte de Medecin/BP 184, Vandoeuvre-les-Nancy, France, 12Rheumatology Department, CHU de ROUEN, Rouen, France, 13Pfizer, Paris, France, 14Rheumatology, Université Paris-Sud, Le Kremlin Bicetre, France, 15Rheumatology, Hopital Bichat, Paris, France, 16Rheumatology Department, Hotel Dieu University hospital, Paris, France, 17Rhumatologie, CHU de la Cavale Blanche, Brest Cedex, France, 18Service de Rhumatologie, Groupe Hospitalier Pellegrin, Bordeaux, France, 19Rhumatologie, CHU Hautepierre, Strasbourg, France

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Rheumatoid Arthritis - Clinical Aspects II: Long-term Outcome of Rheumatoid Arthritis, Observational Studies

Session Type: Abstract Submissions (ACR)

Background/Purpose: To report the five-year outcome of a large national multicentre, longitudinal and prospective cohort of patients with very early arthritis and rheumatoid arthritis (RA) , the so-called “ESPOIR cohort study”.

Methods: Patients were recruited if they had early arthritis of less than 6 months disease duration, a high probability to develop RA, and if they were DMARD and steroids naïve. Patients have been followed every 6 months during the first 2 years then every year. Logistic regression analysis was used to determine predictive factors of outcome.

Results: 813 patients were included. The mean age was 48.1 ± 12.6 years, the main delay for referal was 103.1 ± 52.4 days. DAS28 score was 5.1 ± 1.3, HAQ DI was 1.0 ± 0.7. 44.2 % and 38.8 % had respectively IgM rheumatoid factor or anti-CCP antibodies. These rate remained stable during follow-up. 22 % of the patients had erosions on hand or feet at baseline. 78.5 % of the patients fulfilled the 2010 ACR/EULAR criteria for RA at baseline and 93.8 % during follow-up.573 patients were evaluated at the 5-year follow-up visit. The outcome was rather mild in most of the patients. Disease activity (median DAS28 score: 2.5) and HAQ DI (median: 0.3) were well controlled overtime. The annual rate of radiographic progression was low (2.9 modified Sharp score unit/year). A minority of the patients required joint surgery and no increased risk of co-morbidities was observed. During the 5-year follow-up, 82.7% of the patients received at least one DMARD, which was mainly MTX (n=536; 65.9 %) usually prescribed as monotherapy.18.3 % of the included patients were treated with a biological DMARD and almost 60 % of the whole cohort received at least once, prednisone with a mean dosage of 8.8 ± 7.7 mg/day. Anti-CCP antibodies were the best predictive factor of radiographic progression, prescription of both synthetic or biologic DMARDs or still being followed in the cohort at 5-year

Conclusion: The quite favourable 5-year outcome of this very early RA cohort highlights the need for early referral, early effective treatment and close monitoring in the management of patients with early arthritis in daily practice.

Disclosure:

B. G. Combe,
None;

N. Rincheval,
None;

J. Benessiano,
None;

F. Berenbaum,
None;

A. G. Cantagrel,
None;

J. P. Daurès,
None;

M. Dougados,
None;

P. Fardellone,
None;

B. Fautrel,
None;

R. M. Flipo,
None;

P. M. Goupille,
None;

F. Guillemin,
None;

X. X. Le Loet,
None;

I. Logeart,
None;

X. Mariette,
None;

O. Meyer,
None;

P. Ravaud,
None;

A. Saraux,
None;

T. Schaeverbeke,
None;

J. Sibilia,
None.

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