The aim of treating rheumatoid arthritis (RA) is to establish clinical remission. However, in some regions of the world, it can be challenging. For a study, researchers sought to find the indicators of remission and remission/low disease activity (LDA) in RA.
A longitudinal cohort of real-world RA patients was monitored (January 2016–2020). The following variables were looked at as predictors: gender, age at diagnosis, disease duration, socioeconomic status, tobacco use, rheumatoid factor titer, comorbidities (Charlson index), Simple Disease Activity Index (SDAI) score, disability (Multidimensional Disease Health Assessment Questionnaire), health-related quality of life (Short Form-36 questionnaire), glucocorticoid dose, biological/target synthetic disease-modifying antirheumatic drug use, and conventional DMARD (c-DMARD) use. To identify predictors of remission and maintained remission (2 consecutive visits), using the SDAI criteria (0 or <3.3), univariable and multivariable generalized estimating equation models were created. Similar to this, predictors for remission/LDA (SDAI< 11) were looked at.
The following were among the 530 RA patients: In at least one visit, remission was reached in 160 patients (30.2%), and durable remission was attained in 126 patients (23.77%). Glucocorticoid dose (odds ratio [OR], 1.060; 95% CI, 1.027–1.094; P = 0.004), current (OR, 2.293; 95% CI, 1.811–2.903; P < 0.001), or past (OR, 1.383; 95% CI, 1.127–1.698; P = 0.002) use of c-DMARDs predicted remission/LDA in at least one visit, whereas the SDAI (OR, 0.951; 95% CI, 0.942-0.959; P < 0.001), Multidimensional Disease Health Assessment Questionnaire (OR, 0.648; 95% CI, 0.549–0.764; P < 0.001), and age at diagnosis (OR, 0.994; 95% CI, 0.990–0.998; P = 0.004) were negative predictors. Sustained remission/LDA was predicted by current (OR, 2.012; 95% CI, 1.458-2.776: P< 0.001) or past (OR, 1.517; 95% CI, 1.155-1.993; P = 0.003) use of c-DMARDs, a higher score on the physical component of the Short Form-36 questionnaire (OR, 1.022; 95% CI, 1.014-1.029; P< 0.001) and older age at diagnosis (OR, 1.013; 95% CI, 1.003–1.022; P = 0.008) predicted it, whereas SDAI (OR, 0.949; 95% CI, 0.933–0.965; P < 0.001) and medium-low/low socioeconomic status (OR, 0.674; 95% CI, 0.500–0.909; P = 0.010) were negative predictors.
The use of c-DMARDs predicted remission and remission/LDA during the follow-up of this real-world RA population. In contrast, the presence of an illness was a poor predictor.
