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Clinical Rheumatology

, Volume 34, Issue 1, pp 43–49 | Cite as

The good EULAR response at the first year is strongly predictive of clinical remission in rheumatoid arthritis: results from the TARAC cohort

  • Budsakorn Darawankul
  • Sumapa Chaiamnuay
  • Rattapol Pakchotanon
  • Paijit Asavatanabodee
  • Pongthorn NarongroeknawinEmail author
Original Article

Abstract

The purpose of this study was to identify the prevalence and prognostic factors of clinical remission in patients with rheumatoid arthritis (RA). The Thai Army Rheumatoid Arthritis Cohort (TARAC) patients were included if baseline data were available. Clinical remission was defined as 28-joint count disease activity scores (DAS28) <2.6 in the last two consecutive visits, at least 3 months apart. Three hundred and thirty-five patients were enrolled, and 89.9 % were female. Mean (SD) age was 61 years (11.4), and mean disease duration was 145.9 months (93.7). Rheumatoid factor (RF) and anti-citrullinated protein antibody (ACPA) were positive in 69.9 and 67.8 %, respectively. Eighty-nine percent of patients were treated with synthetic DMARDs, of which 29 % received monotherapy. The combination of biologic and synthetic DMARDs was used in 10.4 % of the patients. Clinical remission was observed in 49 patients (14.6 %). Early diagnosis and treatment within 12 months of onset (odds ratio (OR) 1.95, 95 % confidence interval (CI) 1.02–3.74, p = 0.04), rheumatoid factor negativity (OR 2.10, 95 % CI 1.04–4.21, p = 0.04) and good EULAR response at the end of the first year of treatment (OR 2.75, 95 % CI 1.08–6.99, p = 0.03) were associated with clinical remission in univariate analysis. In multivariate regression analysis, only a good EULAR response at the first year was significantly correlated with clinical remission in this study (OR 3.1, 95 % CI 1.15–8.36, p = 0.03). Although remission is currently a treatment goal in patients with RA, only one-seventh of patients have achieved sustained clinical remission in clinical practice. The good EULAR response at the end of the first year was an independent predictive factor of clinical remission.

Keywords

Prognostic factor Remission Rheumatoid arthritis TARAC cohort 

Notes

Acknowledgments

This study was supported by a research grant from the Thai Rheumatism Association. This manuscript was verified to be correct English by Stephen John Pinder, a native speaker experienced in medical English.

Conflict of interest

The authors declare that there are no conflicts of interest.

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Copyright information

© International League of Associations for Rheumatology (ILAR) 2014

Authors and Affiliations

  • Budsakorn Darawankul
    • 1
  • Sumapa Chaiamnuay
    • 1
  • Rattapol Pakchotanon
    • 1
  • Paijit Asavatanabodee
    • 1
  • Pongthorn Narongroeknawin
    • 1
    Email author
  1. 1.Division of Rheumatology, Department of Internal MedicinePhramongkutklao Hospital and College of MedicineBangkokThailand

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