Session Information
Title: Rheumatoid Arthritis - Clinical Aspects (ACR): Comorbidities, Treatment Outcomes and Mortality
Session Type: Abstract Submissions (ACR)
Background/Purpose
The clinical evaluation of Rheumatoid arthritis (RA) is accomplished with compound indexes allowing better clinical decision. Clinical remission nowadays is an attainable target in the management of RA patients. Clinical remission associated factors are under investigation.
Objetive: Determine which factors are associated with clinical remission by CDAI in a RA population (ACR/EULAR 2010)
Methods
From a rheumatologic diseases cohort in a University Hospital we made an observational, descriptive, retrospective and cross-sectional study of 361 patientes with RA. We analized variables such as demographics, rheumatoid factor, Anti-Cyclic Citrullinated Peptide antibodies, erythrocyte sedimentation rate, C-reactive protein, treatment, clinical activity, visual analog scale, comorbidities, extra-articular manifestations and temporality of RA. CDAI was calculated. Remission was defined with a CDAI score of 2.8.
Results
361 patients were evaluated. Female sex was predominant (97.7%). Mean age was 51.4. Clinical remission was found in 40.2%. When patients with and without clinical remission were compared, we found significant differences in: non use of prednisone (p 0.0001), use of Non-steroidal anti-inflammatory drugs (NSAIDs) (p 0.012), use of tramadol (p 0.0001), absence of osteoarthritis (p 0.33) and BMI <25Kg/m2 (p 0.017). In multivariate analysis factors associated with reach clinical remission were: Non use of oral steroids (p 0.0001, OR 3.39 IC 2.05-5.63) and absence of osteoarthritis (p 0.025, OR 1.8, IC 1.007-3.048). It was found a negative association to reach clinical remission with use of NSAIDs (p 0.008, OR 0.292 , IC 0.117-0.73) and use of tramadol (p 0.003, OR 0.107 , IC 0.024-0.47).
Conclusion
According to our study the presence of OA in patients with RA is a factor that decreases the CDAI specificity for detecting clinical remission. This possibly related to the score given by the patient to the visual analog scale and the presence of painful joints secondary to OA, but not inflamed by RA activity. It is therefore important that clinicians consider these factors when evaluating clinical remission in RA.
Disclosure:
S. Loredo-Alanís,
None;
D. Vega-Morales,
None;
M. Garza-Elizondo,
None;
M. Garcia-Pompermayer,
None;
R. Negrete-López,
None;
D. Treviño-Montes,
None;
D. Flores-Alvarado,
None.
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