Natural remission in inflammatory polyarthritis: issues of definition and prediction.
This paper reports the frequency and predictors of remission (no arthritis on examination and no treatment with second-line drugs or steroids within the previous 3 months) in 358 patients with early inflammatory polyarthritis (IP) referred to the Norfolk Arthritis Register. Two years after referral, 91 patients (25%) were in remission, 32 of whom had also been in remission at 1 yr. Remission rates were twice as high in patients with undifferentiated inflammatory polyarthritis at baseline as in those who satisfied criteria for rheumatoid arthritis. To identify predictors of remission, a logistic regression model was developed on a random two-thirds of the patients and validated on the remaining one-third. Remission at 2 yr was associated with male gender and fewer than six tender joints at baseline. However, even the best-fitting model was not sensitive enough to be useful clinically. Thus, amongst patients with early IP in the community, remission rates at 2 yr are low. Further, it was impossible, using simple clinical measures, to predict those patients whose arthritis would resolve.
Harrison
B J
BJ
ARC Epidemiology Research Unit, Manchester.
Symmons
D P
DP
Brennan
P
P
Barrett
E M
EM
Silman
A J
AJ
D001168:Arthritis / Q000150:complications*; D015331:Cohort Studies; D006801:Humans; D007249:Inflammation / Q000150:complications*; D015999:Multivariate Analysis; D012075:Remission, Spontaneous