Sustained remission improves physical function in patients with established rheumatoid arthritis, and should be a treatment goal: A prospective observational cohort study from southern Sweden

Jon Thorkell Einarsson; Pierre Geborek; Tore Saxne; Lars Erik Kristensen; Meliha C Kapetanovic

doi:10.3899/jrheum.150995

Sustained remission improves physical function in patients with established rheumatoid arthritis, and should be a treatment goal: A prospective observational cohort study from southern Sweden

Jon Thorkell Einarsson^*, Pierre Geborek, Tore Saxne, Lars Erik Kristensen, Meliha C Kapetanovic

^*Corresponding author for this work

12 Citations (Scopus)

Abstract

Objective. It has been proposed that remission should be maintained throughout the course of rheumatoid arthritis (RA); however, the evidence supporting this is limited. Physical function measured by the Health Assessment Questionnaire (HAQ) is a major outcome in RA, and HAQ is shown to be one of the strongest predictors of longterm outcomes. The purpose of this study was to investigate the physical function over a long time in patients with RA who achieved sustained remission (SR) compared with that of patients occasionally achieving remission [non-sustained remission (NSR)]. Methods. Patients with RA treated with antitumor necrosis factor and included in the South Swedish Arthritis Treatment Group register were eligible for this study. We identified patients with a Disease Activity Score at 28 joints (DAS28) < 2.6 or Simplified Disease Activity Index (SDAI) ≤ 3.3 at some point and those who achieved SR, i.e., remission during consecutive visits for at least 6 months. The course of functional status was assessed using the HAQ at each visit. Results. Of the 2416 patients, 1177 (48.7%) reached DAS28 remission at some point. SR was achieved by 382 (15.8%) for the DAS28 and 186 (7.7%) for the SDAI criteria. Comparing the SR and NSR groups, HAQ improved during the first 12 months in the DAS28 remission. HAQ continued to improve relatively as long as SR was maintained. A higher proportion of patients in SR reached full physical function. Conclusion. In patients with established RA, physical function measured by the HAQ improves in patients reaching SR compared with patients who only occasionally reach remission. The improvement continues while in remission, which supports that maintaining remission should be a treatment goal.

Original language	English
Journal	Journal of Rheumatology
Volume	43
Issue number	6
Pages (from-to)	1017-1023
Number of pages	7
ISSN	0315-162X
DOIs	https://doi.org/10.3899/jrheum.150995
Publication status	Published - 2016
Externally published	Yes

Keywords

Biological Therapy
Disease Activity Score
Health Assessment Questionnaire
Remission
Rheumatoid Arthritis

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Sustained remission improves physical function in patients with established rheumatoid arthritis, and should be a treatment goal: A prospective observational cohort study from southern Sweden. / Einarsson, Jon Thorkell; Geborek, Pierre; Saxne, Tore et al.
In: Journal of Rheumatology, Vol. 43, No. 6, 2016, p. 1017-1023.

Research output: Contribution to journal › Journal article › Research › peer-review

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title = "Sustained remission improves physical function in patients with established rheumatoid arthritis, and should be a treatment goal: A prospective observational cohort study from southern Sweden",

abstract = "Objective. It has been proposed that remission should be maintained throughout the course of rheumatoid arthritis (RA); however, the evidence supporting this is limited. Physical function measured by the Health Assessment Questionnaire (HAQ) is a major outcome in RA, and HAQ is shown to be one of the strongest predictors of longterm outcomes. The purpose of this study was to investigate the physical function over a long time in patients with RA who achieved sustained remission (SR) compared with that of patients occasionally achieving remission [non-sustained remission (NSR)]. Methods. Patients with RA treated with antitumor necrosis factor and included in the South Swedish Arthritis Treatment Group register were eligible for this study. We identified patients with a Disease Activity Score at 28 joints (DAS28) < 2.6 or Simplified Disease Activity Index (SDAI) ≤ 3.3 at some point and those who achieved SR, i.e., remission during consecutive visits for at least 6 months. The course of functional status was assessed using the HAQ at each visit. Results. Of the 2416 patients, 1177 (48.7%) reached DAS28 remission at some point. SR was achieved by 382 (15.8%) for the DAS28 and 186 (7.7%) for the SDAI criteria. Comparing the SR and NSR groups, HAQ improved during the first 12 months in the DAS28 remission. HAQ continued to improve relatively as long as SR was maintained. A higher proportion of patients in SR reached full physical function. Conclusion. In patients with established RA, physical function measured by the HAQ improves in patients reaching SR compared with patients who only occasionally reach remission. The improvement continues while in remission, which supports that maintaining remission should be a treatment goal.",

keywords = "Biological Therapy, Disease Activity Score, Health Assessment Questionnaire, Remission, Rheumatoid Arthritis",

author = "Einarsson, {Jon Thorkell} and Pierre Geborek and Tore Saxne and Kristensen, {Lars Erik} and Kapetanovic, {Meliha C}",

year = "2016",

doi = "10.3899/jrheum.150995",

language = "English",

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pages = "1017--1023",

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T1 - Sustained remission improves physical function in patients with established rheumatoid arthritis, and should be a treatment goal

T2 - A prospective observational cohort study from southern Sweden

AU - Einarsson, Jon Thorkell

AU - Geborek, Pierre

AU - Saxne, Tore

AU - Kristensen, Lars Erik

AU - Kapetanovic, Meliha C

PY - 2016

Y1 - 2016

N2 - Objective. It has been proposed that remission should be maintained throughout the course of rheumatoid arthritis (RA); however, the evidence supporting this is limited. Physical function measured by the Health Assessment Questionnaire (HAQ) is a major outcome in RA, and HAQ is shown to be one of the strongest predictors of longterm outcomes. The purpose of this study was to investigate the physical function over a long time in patients with RA who achieved sustained remission (SR) compared with that of patients occasionally achieving remission [non-sustained remission (NSR)]. Methods. Patients with RA treated with antitumor necrosis factor and included in the South Swedish Arthritis Treatment Group register were eligible for this study. We identified patients with a Disease Activity Score at 28 joints (DAS28) < 2.6 or Simplified Disease Activity Index (SDAI) ≤ 3.3 at some point and those who achieved SR, i.e., remission during consecutive visits for at least 6 months. The course of functional status was assessed using the HAQ at each visit. Results. Of the 2416 patients, 1177 (48.7%) reached DAS28 remission at some point. SR was achieved by 382 (15.8%) for the DAS28 and 186 (7.7%) for the SDAI criteria. Comparing the SR and NSR groups, HAQ improved during the first 12 months in the DAS28 remission. HAQ continued to improve relatively as long as SR was maintained. A higher proportion of patients in SR reached full physical function. Conclusion. In patients with established RA, physical function measured by the HAQ improves in patients reaching SR compared with patients who only occasionally reach remission. The improvement continues while in remission, which supports that maintaining remission should be a treatment goal.

AB - Objective. It has been proposed that remission should be maintained throughout the course of rheumatoid arthritis (RA); however, the evidence supporting this is limited. Physical function measured by the Health Assessment Questionnaire (HAQ) is a major outcome in RA, and HAQ is shown to be one of the strongest predictors of longterm outcomes. The purpose of this study was to investigate the physical function over a long time in patients with RA who achieved sustained remission (SR) compared with that of patients occasionally achieving remission [non-sustained remission (NSR)]. Methods. Patients with RA treated with antitumor necrosis factor and included in the South Swedish Arthritis Treatment Group register were eligible for this study. We identified patients with a Disease Activity Score at 28 joints (DAS28) < 2.6 or Simplified Disease Activity Index (SDAI) ≤ 3.3 at some point and those who achieved SR, i.e., remission during consecutive visits for at least 6 months. The course of functional status was assessed using the HAQ at each visit. Results. Of the 2416 patients, 1177 (48.7%) reached DAS28 remission at some point. SR was achieved by 382 (15.8%) for the DAS28 and 186 (7.7%) for the SDAI criteria. Comparing the SR and NSR groups, HAQ improved during the first 12 months in the DAS28 remission. HAQ continued to improve relatively as long as SR was maintained. A higher proportion of patients in SR reached full physical function. Conclusion. In patients with established RA, physical function measured by the HAQ improves in patients reaching SR compared with patients who only occasionally reach remission. The improvement continues while in remission, which supports that maintaining remission should be a treatment goal.

KW - Biological Therapy

KW - Disease Activity Score

KW - Health Assessment Questionnaire

KW - Remission

KW - Rheumatoid Arthritis

U2 - 10.3899/jrheum.150995

DO - 10.3899/jrheum.150995

M3 - Journal article

C2 - 27036384

AN - SCOPUS:84973340578

SN - 0315-162X

VL - 43

SP - 1017

EP - 1023

JO - Journal of Rheumatology

JF - Journal of Rheumatology

IS - 6

ER -

Sustained remission improves physical function in patients with established rheumatoid arthritis, and should be a treatment goal: A prospective observational cohort study from southern Sweden

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Keywords

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