title: Probability of continued low disease activity in patients with recent onset rheumatoid arthritis treated according to the disease activity score.
abstract: OBJECTIVE
  To assess the duration and the probability of maintaining low disease activity once a low disease activity score (DAS) is achieved in recent onset rheumatoid arthritis (RA) patients.
  
  
  METHODS
  The BeSt study is a randomised trial comparing four different treatment strategies in patients with recent onset, active RA. Treatment adjustments were mandatory as long as the DAS was >2.4. If the DAS was <or=2.4, treatment was continued and after 6 months, tapered to maintenance dose. We analysed thrice-monthly DAS calculations in order to assess the duration and the probability of maintaining a DAS <or=2.4.
  
  
  RESULTS
  Patients treated with initial combination therapy achieved a DAS <or=2.4 significantly earlier than patients treated with initial monotherapy. Independent of treatment strategy and without treatment adjustments, the probability of a next DAS <or=2.4 3 months after a first DAS <or=2.4 was 74%. The probability increased to 85% after two preceding DAS <or=2.4 and to 88-97% after one to two preceding DAS<1.6. The median duration of a DAS <or=2.4 was 12 months.
  
  
  CONCLUSIONS
  Once recent onset RA patients achieve a low DAS, the probability of maintaining a low DAS without treatment adjustments is high. This may have implications for the monitoring of patients in daily practice.
authors.affiliation: Department of Rheumatology C-01-R, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands. smvanderkooij@lumc.nl
authors.forename: S M
authors.initials: SM
authors.lastname: van der Kooij
authors.forename: Y P M
authors.initials: YP
authors.lastname: Goekoop-Ruiterman
authors.forename: J K
authors.initials: JK
authors.lastname: de Vries-Bouwstra
authors.forename: A J
authors.initials: AJ
authors.lastname: Peeters
authors.forename: M V
authors.initials: MV
authors.lastname: van Krugten
authors.forename: F C
authors.initials: FC
authors.lastname: Breedveld
authors.forename: B A C
authors.initials: BA
authors.lastname: Dijkmans
authors.forename: C F
authors.initials: CF
authors.lastname: Allaart
mesh_terms: D000465:Algorithms; D000704:Analysis of Variance; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents