In early arthritis patients, high HAQ at baseline and DAS28 at three months predict suboptimal outcomes at two years: a retrospective cohort study

Early arthritis clinics (EAC) aim to improve rheumatoid arthritis (RA) outcomes by tailoring treatment targeting to remission. Our aim was to analyse disease course and relevant predictors over 2 years in early arthritis; we also assessed the applicability of the "treat-to-target approach"...

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Bibliographic Details
Published in:Clinical and experimental rheumatology 2018-09, Vol.36 (5), p.806-813
Main Authors: Fanouriakis, Antonis, Papalopoulos, Ioannis, Gergianaki, Irini, Spyrou, Giorgis, Erden, Abdulsamet, Rapsomaniki, Panagiota, Terizaki, Maria, Avgoustidis, Nestor, Repa, Argyro, Kougkas, Nikolaos, Bertsias, George, Boumpas, Dimitrios T, Sidiropoulos, Prodromos I
Format: Article
Language:English
Subjects:
Adult
Aged
Antirheumatic Agents - therapeutic use
Arthritis, Rheumatoid - diagnosis
Arthritis, Rheumatoid - drug therapy
Arthritis, Rheumatoid - physiopathology
Clinical Decision-Making
Decision Support Techniques
Disability Evaluation
Disease Progression
Female
Health Status
Humans
Male
Middle Aged
Predictive Value of Tests
Remission Induction
Retrospective Studies
Risk Factors
Severity of Illness Index
Time Factors
Treatment Outcome
Turkey
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Summary:Early arthritis clinics (EAC) aim to improve rheumatoid arthritis (RA) outcomes by tailoring treatment targeting to remission. Our aim was to analyse disease course and relevant predictors over 2 years in early arthritis; we also assessed the applicability of the "treat-to-target approach" in a real-life EAC. Patients with early arthritis recruited at the EAC of the University Hospital of Heraklion were followed prospectively according to a follow-up protocol for two years, without implementing a pre-specified treatment protocol, to capture real-life practices. Early predictors of "suboptimal outcomes" (high disease activity or HAQ>1.0 at 2 years) and biologic DMARD (bDMARD) initiation were evaluated with multivariate logistic regression. Intensification of treatment at 3 and 6 months and subsequent long-term outcome were also assessed. 251 patients [RA (n=188), undifferentiated arthritis (n=63)] were included. Although both DAS28 and HAQ at 2 years improved significantly compared to baseline in RA patients [mean (SD) DAS28 and median (IQR) HAQ 3.70 (1.32) and 0.44 (0.75) at 2 years, p
ISSN:0392-856X