Remission in early rheumatoid arthritis treated with conventional DMARDs. Results of a two-year follow-up study of El Ayachi Moroccan cohort

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• 作者：Karima Benbouazza^a ; Hanan Rkain^a ; ^{hananrkain@yahoo.fr} ; Bahia Benchekroun^a ; Bouchra Amine^a ; Fatiha Bzami^a ; Leila Benbrahim^a ; Ouafa Atouf^b ; Malika Essakalli^b ; Redouane Abouqal^c ; Maxime Dougados^d ; Najia Hajjaj-Hassouni^a
• 关键词：Early rheumatoid arthritis ; Morocco ; DMARDs ; Methotrexate ; DAS28 ; Remission
• 刊名：Joint Bone Spine
• 出版年：2012
• 出版时间：January, 2012
• 年：2012
• 卷：79
• 期：1
• 页码：43-46
• 全文大小：240 K

文摘

Objective

This study aimed to evaluate remission in patients with early RA treated by conventional DMARDs and to identify its possible predictor factors.

Methods

Patients with early RA (< 12 months) were enrolled in a 2-year follow-up study. Standard evaluation completed at baseline and at 24 months included clinical, laboratory, functional and structural assessment. Clinical remission after 2 years of follow-up was defined when DAS28 was less than 2.6. Possible predictor factors for remission were analyzed.

Results

Fifty-one patients (88.2 % women, mean age of 46.9 [24-72] years, mean disease duration of 24 [6-48] weeks) were enrolled in this study. The delay in referral for specialist care was 140 [7-420] days. Rheumatoid factor, anti-CCP, HLA-DRB1*01 and DRB1*04 alleles were present respectively in 62.5, 56.6, 11.8, and 45.1 % of patients. At 24 months, 77.2 % received a median dose of 5 (0-8) mg/day of prednisone and 65.2 % was taking methotrexate (MTX). 13.6 % of patients had stopped their DMARD because of socioeconomic difficulties. At 24 months, we noted a significant improvement of morning stiffness, pain score, swollen joint count, ESR, CRP, DAS28 and HAQ scores. Remission at 2 years was noted in 34.8 % of patients and was significantly associated in univariate but not in multivariate analysis to male sex (P = 0.02) and to short delay in referral for specialist (P = 0.03).

Conclusion

In this cohort of early RA patients treated with conventional DMARDs, especially with methotrexate in monotherapy, remission at 2-year of follow-up was obtained in one third of patients. No predictor factors of remission were found out. These results should be verified by further studies.