Session Information
Date: Wednesday, October 24, 2018
Title: 6W023 ACR Abstract: RA–DX, Manifestations, & Outcomes VI: Outcomes Reports (2982–2987)
Session Type: ACR Concurrent Abstract Session
Session Time: 11:00AM-12:30PM
Background/Purpose:
Remission is arguably the best and ultimate therapeutic goal in early rheumatoid arthritis (ERA). ERA patients
(pts) who reach rapid and sustained remission are likely to retain good radiographic outcomes. The aim of this
study was to evaluate the radiographic progression and the newly pathological joints in a Belgian ERA cohort
during a 5 years follow-up and to correlate the Sharp score index with different indices of clinical remission
observed during the first year.
Methods:
This was a retrospective analysis of mean (95% CI) change from baseline (BL) to 5 years Sharp/Van der Heijde
(SVdH) scoring according to DAS28, SDAI, CDAI and ACR/EULAR Boolean remission scores for pts at
Month 3, 6 and 12. Newly pathological joint defined by a SVdH score of 0 at BL and a score greater than or
equal to 1 at follow up were analyzed as a secondary objective. 133 ERA pts naïve to DMARDs therapies were
analyzed (100 women and 33 men) with a mean age (49.9 +/- 13.3), mean DAS 28-CRP (4.89 +/- 1.3), mean
HAQ (1.25 +/- 0.67), mean SDAI (28.4 +/- 15.5), mean CDAI (25.8 +/- 14.8) and mean SVdH (6 +/- 14).
Differences were statistically tested using t tests.
Results:
ERA ps were divided in 2 groups : "Xrays Stable" if the delta of SVdH score was ≤10 (n=90) or "Xrays
Progressive" if the delta of SVdH score was >10 (n=43). As expected, number of pts with ACPA and BL
erosion was higher in the Xrays Progressive group. No significant BL characteristics differences were observed
for DAS28CRP, CDAI, SDAI, HAQ, smoking status, swollen joint count or CRP. % of pts reaching
DAS28CRP, SDAI, CDAI and Boolean remission rates observed at 6 months were statistically significant
different between groups (fig). Boolean remission was the most stringent test with a statistical difference
observed also at month 3 (specificity 90.5%, sensitivity 32.2%). There was no significant difference in clinical
responses between subgroups of pts who developed new pathological joints and those who did not.
Conclusion:
These results demonstrate that remission is an important therapeutic goal to protect joint damage in ERA. All
remission criteria were able to predict the radiological prevention. The identification of a new pathologic joint is
not associated with lack of response.
Disclosure: J. Legrand, None; T. Kirchgesner, None; T. Sokolova, None; B. Vande Berg, None; P. Durez, None.
To cite this abstract in AMA style:
Legrand J, Kirchgesner T, Sokolova T, Vande Berg B, Durez P. RAPID Remission during the First Year in EARLY ACTIVE Rheumatoid Arthritis Is Associated with Better 5 YEARS Structural Damage Outcomes [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/rapid-remission-during-the-first-year-in-early-active-rheumatoid-arthritis-is-associated-with-better-5-years-structural-damage-outcomes/. Accessed .« Back to 2018 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/rapid-remission-during-the-first-year-in-early-active-rheumatoid-arthritis-is-associated-with-better-5-years-structural-damage-outcomes/