Probability of continued low disease activity in patients with recent onset rheumatoid arthritis treated according to the disease activity score.
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.
van der Kooij
S M
SM
Department of Rheumatology C-01-R, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands. smvanderkooij@lumc.nl
Goekoop-Ruiterman
Y P M
YP
de Vries-Bouwstra
J K
JK
Peeters
A J
AJ
van Krugten
M V
MV
Breedveld
F C
FC
Dijkmans
B A C
BA
Allaart
C F
CF
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
D018501:Antirheumatic Agents