Prognostic factors for remission in early rheumatoid arthritis: a multiparameter prospective study.
OBJECTIVE
To determine prognostic factors for remission in early rheumatoid arthritis.


METHODS
191 patients with rheumatoid arthritis whose disease duration was less than one year were followed up prospectively for five years. Remission, defined by a disease activity score (DAS) of <1.6, was used as the outcome measure. Baseline clinical, laboratory, genetic, and radiographic data (with radiographic scores determined by Sharp's method, modified by van der Heijde) were obtained.


RESULTS
48 patients (25.1%) fulfilled the remission criteria at the three year follow up visit, and 30 (15.7%) at three and five years. On univariate analysis by Fisher's exact test, remission at three years and persistent remission at five years were closely correlated with baseline DAS values, C reactive protein level, Ritchie score, health assessment questionnaire score, duration of morning stiffness, and to a lesser extent baseline total radiological scores and rheumatoid factor negativity. No significant correlation was found with sex, age, extra-articular manifestations, erythrocyte sedimentation rate, anti-cyclic citrullinated protein antibodies, anti-keratin antibodies, anti-HSP 90, anticalpastatin antibodies, antinuclear antibodies, or HLA-DRB1* genotypes. Logistic regression analysis showed that the baseline independent variables predictive of remission were low DAS, Ritchie score, morning stiffness duration, and total radiographic score.


CONCLUSIONS
Baseline prognostic factors for remission in early rheumatoid arthritis were mainly clinical markers of disease activity and radiological scores.
Gossec
L
L
René Descartes University, Cochin Hospital, Department of Rheumatology B, Paris, France.
Dougados
M
M
Goupille
P
P
Cantagrel
A
A
Sibilia
J
J
Meyer
O
O
Sany
J
J
Daurès
J-P
JP
Combe
B
B
D000704:Analysis of Variance; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy*; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011859:Radiography; D012074:Remission Induction; D012217:Rheumatoid Factor / Q000097:blood; D012720:Severity of Illness Index
D018501:Antirheumatic Agents; D002097:C-Reactive Protein; D012217:Rheumatoid Factor