Early Remission at 6 Months as a Predictor of Longterm Remission in New Onset Rheumatoid Arthritis

BackgroundEarly therapeutic intervention is crucial for patients with early rheumatoid arthritis (ERA). The goal of remission is achievable in a large proportion of ERA patients.ObjectivesTo evaluate the rate of patients in remission at 6 months and to correlate the 36 and 60 months remission rate in the Belgian CAP48 cohort and the UCLouvain Brussels cohort. To identify baseline characteristics differences between patients achieving remission or not.MethodsWe included patients with ERA from the CAP48 cohort and from the UCLouvain Brussels cohort who met the ACR/EULAR 2010 RA classification criteria. All patients were naïve to csDMARDs therapy. We collected patient characteristics at baseline and clinical response was analysed at 6, 36 and 60 months.Results287 RA patients from our UCLouvain Brussels Cohort and the CAP48 cohort were analysed (211 Females, 76 Males, mean age 46.2 years, 43.4% with baseline erosion, 70.1% with ACPA, 70.3% with Rheumatoid Factor, mean HAQ 1.16, mean DAS28-CRP 4.67, mean SDAI 24.9 and mean CDAI 24.1).Table 1.The clinical results are summarized in the Table.DAS28-CRPMean(±SD)SDAIMean(±SD)CDAIMean(±SD)Remission(DAS28-CRP), %HAQMean(±SD)Baseline n=2874.67 (±1.38)26.5 (±15.5)24.1 (±14.4)/1.16 (±0.70)Months 6 n=2872.97 (±1.34)11.3(±12.3)10.5 (±11.8)44,9%0.60 (±0.62)Months 36 n=2872.24 (±1.04)7.5(±8.6)6.2 (±7.8)71,1%0.52 (±0.59)Months 60 n=1962.41 (±1.00)6.4(±6.5)5.7 (±6.2)66,3%0.56 (±0.63)We divided the patients according to whether they achieved remission DAS28-CRP < 2.6 (group 1), or not (group 2) at 6 months.Patient baseline characteristics were similar in the two groups respectively: age (46.7 vs 45.4 yrs); female (68.5 vs 77.3%); smoker (25.6 vs 27.0%); ACPA positive (70.1 vs 75.4%); baseline X-ray erosion (45.0 vs 54.7%).DAS28-CRP, SDAI and CDAI at 6 months could predict long-term remission at 36 and 60 months, Figure:Figure 1.In group 1 global remission (DAS28-CRP<2.6, HAQ<0.5 and no X-ray progression) was observed in 75.6% at 60 months. The majority of these patients (69.4%) are still treated with Methotrexate, the others were treated with combination therapy.ConclusionEarly and long term remission is an achievable goal in our two cohorts. Early diagnosis is critical in standard of care. At 6 months, all remission index criteria are good predictor for long term remission and could be used in daily care.Disclosure of InterestsNone declared