sustained rheumatoid arthritis remission is uncommon in clinical practice在临床实践中持续的类风湿关节炎缓解期是罕见.pdf

Prince et al. Arthritis Research Therapy 2012, 14:R68 /content/14/2/R68 RESEARCH ARTICLE Open Access Sustained rheumatoid arthritis remission is uncommon in clinical practice * Femke HM Prince , Vivian P Bykerk, Nancy A Shadick, Bing Lu, Jing Cui, Michelle Frits, Christine K Iannaccone, Michael E Weinblatt and Daniel H Solomon Abstract Introduction: Remission is an important goal of therapy in rheumatoid arthritis (RA), but data on duration of remission are lacking. Our objective was to describe the duration of remission in RA, assessed by different criteria. Methods: We evaluated patients from the Brigham and Women’s Rheumatoid Arthritis Sequential Study (BRASS) not in remission at baseline with at least 2 years of follow-up. Remission was assessed according to the Disease Activity Score 28-C-reactive protein (DAS28-CRP4), Simplified Disease Activity Index (SDAI), and Clinical Disease Activity Index (CDAI) scores, and the recently proposed American College of Rheumatology (ACR)/European League against Rheumatism (EULAR) criteria for remission. Analyses were performed by using Kaplan-Meier survival curves. Results: We identified 871 subjects with ≥2 years of follow-up. Of these subjects, 394 were in remission at one or more time-points and not in remission at baseline, according to at least one of the following criteria: DAS28-CRP 2.6 (n = 309), DAS28-CRP 2.3 (n = 275), SDAI (n = 168), CDAI (n = 170), and 2010 ACR/EULAR (n = 158). The median age for the 394 subjects at entrance to BRASS was 56 years; median disease duration was 8 years; 81% were female patients; and 72% were seropositive. Survival analysis performed separately for each remission criterion demonstrated that 50% of subjects remained in remission 1 year later. Median remission survival time was 1 year. Kaplan-Meier curves