Physician global assessment at 3 months is strongly predictive of remission at 12 months in early rheumatoid arthritis: results from the CATCH cohort.
OBJECTIVE
The objective of this study was to determine predictors of 1-year remission in early RA (ERA) using baseline and 3-month data.


METHODS
The Canadian Early Arthritis Cohort (CATCH) patients were included if baseline, 3- and 12-month data were available. Regression analyses for four different definitions of remission at 12 months were done to determine baseline and 3-month predictors of remission.


RESULTS
Five hundred and sixty-two patients had complete data at 12 months (mean age 53.4 years, disease duration 6.2 years, 73% female). The factors at baseline associated with all four remission outcomes at 12 months were age, gender, income, education, tender joint count (TJC), patient global assessment (PtGA), HAQ and pain. Baseline ESR was associated with the 28-joint DAS (DAS28) remission only. At 3 months, all four remission definitions were associated with TJC, swollen joint count, physician global assessment (PGA), PtGA, HAQ, pain, ESR and CRP in univariate analyses. In the regression model, variables associated with Simple Disease Activity Index remission were PGA [odds ratio (OR) 0.77, P < 0.001), pain (OR 0.85, P = 0.004), age (OR 0.98, P = 0.006) and HAQ (OR 0.49, P = 0.011); Clinical Disease Activity Index remission was associated with PGA (OR 0.77, P < 0.001), pain (OR 0.85, P = 0.003), age (OR 0.98, P = 0.015) and CRP (OR 0.80, P = 0.031). DAS28 remission was predicted by ESR (OR 0.95, P < 0.001), PGA (OR 0.76, P < 0.001), age (OR 0.98, P = 0.001), HAQ (OR 0.57, P = 0.006) and male gender (OR 2.01, P = 0.005), whereas Boolean remission was associated with pain (OR 0.79, P = 0.009), age (OR 0.98, P = 0.016), PtGA (OR 0.83, P = 0.025) and PGA (OR 0.86, P = 0.038).


CONCLUSIONS
A low PGA at 3 months was consistently associated with 1-year remission in ERA.
Department of Rheumatology, St Joseph's Health Care, 268 Grosvenor St., London, ON, N6A 4V2, Canada. janet.pope@sjhc.london.on.ca.
Tommy
T
Choy
Vivian P
VP
Bykerk
Gilles
G
Boire
Boulos P
BP
Haraoui
Carol
C
Hitchon
Carter
C
Thorne
Edward C
EC
Keystone
Janet E
JE
Pope
D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D001688:Biological Products / Q000627:therapeutic use*; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010147:Pain Measurement / Q000379:methods*; D063868:Patient Outcome Assessment; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome
D018501:Antirheumatic Agents; D001688:Biological Products; D005938:Glucocorticoids; D002097:C-Reactive Protein
CATCH cohort; DAS; DMARDs; ERA; SJC; physician global assessment