TY - JOUR
T1 - Clinical predictors of remission and low disease activity in Latin American early rheumatoid arthritis
T2 - data from the GLADAR cohort
AU - Gamboa-Cárdenas, Rocio V.
AU - Ugarte-Gil, Manuel F.
AU - Loreto, Massardo
AU - Sacnun, Mónica P.
AU - Saurit, Verónica
AU - Cardiel, Mario H.
AU - Soriano, Enrique R.
AU - Pisoni, Cecilia
AU - Galarza-Maldonado, Claudio M.
AU - Rios, Carlos
AU - Radominski, Sebastião C.
AU - Castelar-Pinheiro, Geraldo da R.
AU - Bianchi, Washington Alves
AU - Appenzeller, Simone
AU - da Silveira, Inés Guimarães
AU - de Freitas Zerbini, Cristiano A.
AU - Caballero-Uribe, Carlo V.
AU - Rojas-Villarraga, Adriana
AU - Guibert-Toledano, Marlene
AU - Ballesteros, Francisco
AU - Montufar, Rubén
AU - Vázquez-Mellado, Janitzia
AU - Esquivel-Valerio, Jorge
AU - De La Torre, Ignacio García
AU - Barile-Fabris, Leonor A.
AU - Palezuelos, Fedra Irazoque
AU - Andrade-Ortega, Lilia
AU - Monge, Pablo
AU - Teijeiro, Raquel
AU - Achurra-Castillo, Ángel F.
AU - Esteva Spinetti, María H.
AU - Alarcón, Graciela S.
AU - Pons-Estel, Bernardo A.
N1 - Publisher Copyright:
© 2019, International League of Associations for Rheumatology (ILAR).
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Objectives: To identify baseline predictors of remission and low disease activity (LDA) in early rheumatoid arthritis (RA) from the GLADAR (Grupo Latino Americano De estudio de la Artritis Reumatoide) cohort. Methods: Patients with 1- and 2-year follow-up visits were included. Remission and LDA were defined by DAS28-ESR (< 2.6 and ≤ 3.2, respectively). Baseline predictors examined were gender, ethnicity, age at diagnosis, socioeconomic status, symptoms’ duration, DMARDs, RF, thrombocytosis, anemia, morning stiffness, DAS28-ESR (and its components), HAQ-DI, DMARDs and corticosteroid use, and Sharp-VDH score. Multivariable binary logistic regression models (excluding DAS28-ESR components to avoid over adjustment) were derived using a backward selection method (α-level set at 0.05). Results: Four hundred ninety-eight patients were included. Remission and LDA/remission were met by 19.3% and 32.5% at the 1-year visit, respectively. For the 280 patients followed for 2 years, these outcomes were met by 24.3% and 38.9%, respectively. Predictors of remission at 1 year were a lower DAS28-ESR (OR 1.17; CI 1.07–1.27; p = 0.001) and HAQ-DI (OR 1.48; CI 1.04–2.10; p = 0.028). At 2 years, only DAS28-ESR (OR 1.40; CI 1.17–1.6; p < 0.001) was a predictor. Predictors of LDA/remission at 1 year were DAS28-ESR (OR 1.42; CI 1.26–1.61; p < 0.001), non-use of corticosteroid (OR 1.74; CI 1.11–2.44; p = 0.008), and male gender (OR 1.77; CI 1.2–2.63; p = 0.036). A lower baseline DAS28-ESR (OR 1.45; CI 1.23–1.70; p < 0.001) was the only predictor of LDA/remission at 2 years. Conclusions: A lower disease activity consistently predicted remission and LDA/remission at 1 and 2 years of follow-up in early RA patients from the GLADAR cohort.Key Points• In patients with early RA, a lower disease activity at first visit is a strong clinical predictor of achieving remission and LDA subsequently.• Other clinical predictors of remission and LDA to keep in mind in these patients are male gender, non-use of corticosteroids and low disability at baseline.• Not using corticosteroids at first visit is associated with a lower disease activity and predicts LDA/remission at 1 year in these patients.
AB - Objectives: To identify baseline predictors of remission and low disease activity (LDA) in early rheumatoid arthritis (RA) from the GLADAR (Grupo Latino Americano De estudio de la Artritis Reumatoide) cohort. Methods: Patients with 1- and 2-year follow-up visits were included. Remission and LDA were defined by DAS28-ESR (< 2.6 and ≤ 3.2, respectively). Baseline predictors examined were gender, ethnicity, age at diagnosis, socioeconomic status, symptoms’ duration, DMARDs, RF, thrombocytosis, anemia, morning stiffness, DAS28-ESR (and its components), HAQ-DI, DMARDs and corticosteroid use, and Sharp-VDH score. Multivariable binary logistic regression models (excluding DAS28-ESR components to avoid over adjustment) were derived using a backward selection method (α-level set at 0.05). Results: Four hundred ninety-eight patients were included. Remission and LDA/remission were met by 19.3% and 32.5% at the 1-year visit, respectively. For the 280 patients followed for 2 years, these outcomes were met by 24.3% and 38.9%, respectively. Predictors of remission at 1 year were a lower DAS28-ESR (OR 1.17; CI 1.07–1.27; p = 0.001) and HAQ-DI (OR 1.48; CI 1.04–2.10; p = 0.028). At 2 years, only DAS28-ESR (OR 1.40; CI 1.17–1.6; p < 0.001) was a predictor. Predictors of LDA/remission at 1 year were DAS28-ESR (OR 1.42; CI 1.26–1.61; p < 0.001), non-use of corticosteroid (OR 1.74; CI 1.11–2.44; p = 0.008), and male gender (OR 1.77; CI 1.2–2.63; p = 0.036). A lower baseline DAS28-ESR (OR 1.45; CI 1.23–1.70; p < 0.001) was the only predictor of LDA/remission at 2 years. Conclusions: A lower disease activity consistently predicted remission and LDA/remission at 1 and 2 years of follow-up in early RA patients from the GLADAR cohort.Key Points• In patients with early RA, a lower disease activity at first visit is a strong clinical predictor of achieving remission and LDA subsequently.• Other clinical predictors of remission and LDA to keep in mind in these patients are male gender, non-use of corticosteroids and low disability at baseline.• Not using corticosteroids at first visit is associated with a lower disease activity and predicts LDA/remission at 1 year in these patients.
KW - Early RA outcomes
KW - Early RA remission
KW - Early RA response predictors
KW - Latin America early RA
UR - http://www.scopus.com/inward/record.url?scp=85066836434&partnerID=8YFLogxK
U2 - 10.1007/s10067-019-04618-x
DO - 10.1007/s10067-019-04618-x
M3 - Artículo
C2 - 31161486
AN - SCOPUS:85066836434
SN - 0770-3198
VL - 38
SP - 2737
EP - 2746
JO - Clinical Rheumatology
JF - Clinical Rheumatology
IS - 10
ER -