Prognostic factors for remission in early RA: a multiparameter prospective study

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Ann Rheum Dis. 2004 Jun;63(6):675-80.

Prognostic factors for remission in early rheumatoid arthritis: a

multiparameter prospective study.

Gossec L, Dougados M, Goupille P, Cantagrel A, Sibilia J, Meyer O, Sany

J, Daures JP, Combe B.

Service d'Immuno-Rhumatologie, Hopital Lapeyronie, 371 Avenue du doyen

Gaston Giraud, 34295 Montpellier Cedex 5, France.

b-combe@...

OBJECTIVE: To determine prognostic factors for remission in early

rheumatoid arthritis. METHODS: 191 patients with rheumatoid arthritis

whose disease duration was less than one year were followed up

prospectively for five years. Remission, defined by a disease activity

score (DAS) of <1.6, was used as the outcome measure. Baseline clinical,

laboratory, genetic, and radiographic data (with radiographic scores

determined by Sharp's method, modified by van der Heijde) were obtained.

RESULTS: 48 patients (25.1%) fulfilled the remission criteria at the

three year follow up visit, and 30 (15.7%) at three and five years. On

univariate analysis by Fisher's exact test, remission at three years and

persistent remission at five years were closely correlated with baseline

DAS values, C reactive protein level, Ritchie score, health assessment

questionnaire score, duration of morning stiffness, and to a lesser

extent baseline total radiological scores and rheumatoid factor

negativity. No significant correlation was found with sex, age,

extra-articular manifestations, erythrocyte sedimentation rate,

anti-cyclic citrullinated protein antibodies, anti-keratin antibodies,

anti-HSP 90, anticalpastatin antibodies, antinuclear antibodies, or

HLA-DRB1* genotypes. Logistic regression analysis showed that the

baseline independent variables predictive of remission were low DAS,

Ritchie score, morning stiffness duration, and total radiographic score.

CONCLUSIONS: Baseline prognostic factors for remission in early

rheumatoid arthritis were mainly clinical markers of disease activity

and radiological scores.

PMID: 15140774

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