The objective of this study is to evaluate the remission rate and describe the current use of medication in a large cohort of rheumatoid arthritis (RA) patients under routine clinical care in China. RA patients were recruited from 40 large teaching hospitals nationwide in China. Data regarding RA disease activity, medication treatment, and adverse events were recorded using a standardized clinical data questionnaire. RA remission was evaluated by the 28 Joint Disease Activity Score DAS28-ESR Clinical Disease Activity Index (CDAI), Simplified Disease Activity Index (SDAI), and American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) remission criteria. A total of 1945 patients with RA were included in the study. The proportions of patients who fulfilled the DAS28-ESR, CDAI, SDAI, and ACR/EULAR remission criteria were 10.90%, 6.17%, 5.04% , and 1.75%, respectively. Most patients had taken at least one disease-modifying anti-rheumatic drug (DMARD), and the most common prescriptions included leflunomide (LEF) and methotrexate (MTX). DMARD combined with botanics were the most common and dominant strategy for RA management (29.16%). Overall, 433 patients (22.27%) had at least one adverse event. Gastrointestinal adverse events (41.27%) were the most frequently reported events. The incidence of side effects in patients using biologics DMARDs (bDMARDs) was significantly lower than that in those taking MTX, LEF, or sulfasalazine (SSZ). The remission rate of RA disease activity, as assessed in Chinese clinical practice, was very low. Adverse effects of the medicine occurred in approximately one in five RA patients, with bDMARDs were demonstrated to be the medication with the lowest side effects.
Adverse events DMARDs Disease activity Medical options Rheumatoid arthritis
disease-modifying anti-rheumatic drugs
Clinical Disease Activity Index
Simplified disease Activity Index
European League Against Rheumatism
American College of Rheumatology
Health Assessment Questionnaire Disability Index
total glucosides of Paeonia
swollen joint count
tender joint count
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The authors would like to thank all participating patients, study nurses, and all colleagues.
Huaqun Zhu and Ru Li performed most of the research. Yin Su and Zhanguo Li conceived the study and participated in the design and in the interpretation of results. All authors participated in the study conception and design and participated in the acquisition of data, and analysis and interpretation of data. All authors read and approved the manuscript.
This work was supported by grants from the National Natural Science Foundation of China (81172844, 81471600, 31530020, and 81120108020) and the National Sci-Tech Support Program (2008BAI59B01 and 2014BAI07B01).
Compliance with ethical standards
Ethics approval and consent to participate
The study was approved by the Institutional Medical Ethics Review Board of Peking University People’s Hospital. The participants gave informed consent to participate.
Consent for publication
All authors have read and approved the final version of the manuscript for publication.
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