Background/Purpose: Remission constitutes the best achievable state in patients with rheumatoid arthritis (RA). And if remission is a goal, it need to be maintained. The objective of this study was to evaluate stable remission in (RA) over 7 years follow-up in “real life” conditions and its predicitive factors.

Methods:  The records (clinical, biological, immunogenetic, and radiographical data ) of 364 patients with active RA, fulfilling the American College of Rheumatology (ACR) criteria, seen between January 2008 and December 2008 in a University Hospital Rheumatology were analyzed. Mean age was 62,9 years. 188 were treated with cDMARDs (monotherapy or association), 86 were treated with bioDMARDs (monotherapy or combined with methotrexate), 36 had only corticosteroids. The ACR-EULAR remission, defined as DAS28 <2.6 was achieved by 97 patients after 1 year ( 39 patients had only cDMARDs, 49 had bioDMARDs (43 anti-TNF and 6 others), 9 had no long-term treatment. Patients were seen at least once a year In out patient clinic. All data were collected until end of 2015.

Results: Data from 233 patients (75%) followed up to 7 years were avalaible. Remission was obtained for 133 patients (57%).102 were treated with cDMARDs (monotherapy with methotrexate, arava, plaquenil or tritherapy),130 were treated with bioDMARDs (30 had monotherapy and 100 had combined treatment with cDMARDs), 1 had only corticosteroids. Mean activity in DAS28 was 3,44 after 1 year and dicreases to 2,67 after 7 years follow up. Corticosteroids have been stopped for 38% of our patients. Among the 97 patients getting strict remission after 1 year, 82 patients (84%) kept long term remission and 51 others entered in remission during follow up. Remission rate was 31% after 1 year, remained stable for 84% of our patients and long term remission rates (DAS28<2.6) was obtain for 57% of our patients, and 38 patients (16%) kept a low disease activity (DAS28 <3,2). Long term remission was more frequent when cDMARDs was associated with bioDMARDs, especially anti-TNF.

Conclusion:  In our study 84% of patients who had remission after 1 year of treatment kept long term remission. In RA patients, targeted treatment with a combination of conventional DMARDs and biologic induces a higher rate of long term remission.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/maintained-remission-in-rheumatoid-arthritis-over-7-years-in-real-life-conditions-a-monocentric-observational-study/