title: Remission in early rheumatoid arthritis treated with conventional DMARDs. Results of a two-year follow-up study of El Ayachi Moroccan cohort.
abstract: OBJECTIVE
  This study aimed to evaluate remission in patients with early RA treated by conventional DMARDs and to identify its possible predictor factors.
  
  
  METHODS
  Patients with early RA (<12 months) were enrolled in a 2-year follow-up study. Standard evaluation completed at baseline and at 24 months included clinical, laboratory, functional and structural assessment. Clinical remission after 2 years of follow-up was defined when DAS28 was less than 2.6. Possible predictor factors for remission were analyzed.
  
  
  RESULTS
  Fifty-one patients (88.2% women, mean age of 46.9 [24-72] years, mean disease duration of 24 [6-48] weeks) were enrolled in this study. The delay in referral for specialist care was 140 [7-420] days. Rheumatoid factor, anti-CCP, HLA-DRB1*01 and DRB1*04 alleles were present respectively in 62.5, 56.6, 11.8, and 45.1% of patients. At 24 months, 77.2% received a median dose of 5 (0-8) mg/day of prednisone and 65.2% was taking methotrexate (MTX). 13.6% of patients had stopped their DMARD because of socioeconomic difficulties. At 24 months, we noted a significant improvement of morning stiffness, pain score, swollen joint count, ESR, CRP, DAS28 and HAQ scores. Remission at 2 years was noted in 34.8% of patients and was significantly associated in univariate but not in multivariate analysis to male sex (P=0.02) and to short delay in referral for specialist (P=0.03).
  
  
  CONCLUSIONS
  In this cohort of early RA patients treated with conventional DMARDs, especially with methotrexate in monotherapy, remission at 2-year of follow-up was obtained in one third of patients. No predictor factors of remission were found out. These results should be verified by further studies.
authors.affiliation: Rheumatology Department, Mohamed Vth University Souissi, El Ayachi Hospital, Salé, Ibn Sina Universitary Hospital, Rabat, Morocco.
authors.forename: Karima
authors.initials: K
authors.lastname: Benbouazza
authors.forename: Hanan
authors.initials: H
authors.lastname: Rkain
authors.forename: Bahia
authors.initials: B
authors.lastname: Benchekroun
authors.forename: Bouchra
authors.initials: B
authors.lastname: Amine
authors.forename: Fatiha
authors.initials: F
authors.lastname: Bzami
authors.forename: Leila
authors.initials: L
authors.lastname: Benbrahim
authors.forename: Ouafa
authors.initials: O
authors.lastname: Atouf
authors.forename: Malika
authors.initials: M
authors.lastname: Essakalli
authors.forename: Redouane
authors.initials: R
authors.lastname: Abouqal
authors.forename: Maxime
authors.initials: M
authors.lastname: Dougados
authors.forename: Najia
authors.initials: N
authors.lastname: Hajjaj-Hassouni
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D059811:HLA-DRB1 Chains / Q000235:genetics; D006304:Health Status; D006801:Humans; D006930:Hyperalgesia / Q000188:drug therapy / Q000503:physiopathology; D007596:Joints / Q000187:drug effects / Q000503:physiopathology; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D009018:Morocco; D011241:Prednisone / Q000627:therapeutic use; D012074:Remission Induction; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents; D059811:HLA-DRB1 Chains; D011241:Prednisone; D008727:Methotrexate