title: Aiming for SDAI remission versus low disease activity at 1 year after inclusion in ESPOIR cohort is associated with better 3-year structural outcomes.
abstract: OBJECTIVE
  Using data for patients with early rheumatoid arthritis (RA) from the ESPOIR cohort, we aimed to evaluate the impact of remission versus low disease activity (LDA) by the Simple Disease Activity Index (SDAI) at 1 year on 3-year structural damage assessed by the modified Sharp-van der Heijde total score (mTSS) and functional impairment assessed by the Health Assessment Questionnaire Disability Index (HAQ-DI).
  
  
  METHODS
  We included 625 patients from the ESPOIR cohort who fulfilled the 2010 American College of Rheumatology/European League Against Rheumatism criteria for RA at baseline and had an SDAI score at 1 year. mTSS and HAQ-DI scores were compared at 3 years for patients with SDAI remission or LDA status at 1 year. A linear mixed model was used to assess the independent effect of SDAI status at 1 year on mTSS and HAQ-DI at 3 years.
  
  
  RESULTS
  Of the 625 patients included (mean (SD) age 48.5 (12.1) years; 491 (78.6%) were women), 121 (19.4%) were in SDAI remission and 223 (35.7%) in LDA at 1 year. The mean (SD) mTSS and HAQ-DI score at 3 years was 9.6 (9.2) and 0.23 (0.42), respectively, for patients in remission at 1 year and 15.8 (16.1) and 0.43 (0.52), respectively, for patients with LDA (both p<0.05). Multivariate analysis revealed an association of remission rather than LDA status at 1 year and reduced mTSS score (p=0.005) but not HAQ-DI score (p=0.4) at 3 years.
  
  
  CONCLUSIONS
  Aiming for SDAI remission rather than LDA at 1 year leads to better radiographic outcomes at 3 years in early RA patients.
authors.affiliation: UMR 1027, INSERM, Toulouse, France UMR 1027, University Paul Sabatier Toulouse III, Toulouse, France Rheumatology Center, Purpan Hospital, Toulouse, France.
authors.forename: Adeline
authors.initials: A
authors.lastname: Ruyssen-Witrand
authors.affiliation: UMR 1027, INSERM, Toulouse, France UMR 1027, University Paul Sabatier Toulouse III, Toulouse, France.
authors.forename: Gregory
authors.initials: G
authors.lastname: Guernec
authors.affiliation: Rheumatology Center, Purpan Hospital, Toulouse, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Nigon
authors.affiliation: Rheumatology Department, Cavale Blanche Hospital, Brest, France.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Tobon
authors.affiliation: Rheumatology Center, Purpan Hospital, Toulouse, France.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Jamard
authors.affiliation: Rheumatology Department, CHU Bravois, Vandoeuvre les Nancy, France.
authors.forename: Anne-Christine
authors.initials: AC
authors.lastname: Rat
authors.affiliation: Rheumatology Department, CHU de Rouen, Rouen, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Vittecoq
authors.affiliation: Rheumatology Center, Purpan Hospital, Toulouse, France JE2510, University Paul Sabatier Toulouse III, Toulouse, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Cantagrel
authors.affiliation: UMR 1027, INSERM, Toulouse, France UMR 1027, University Paul Sabatier Toulouse III, Toulouse, France Rheumatology Center, Purpan Hospital, Toulouse, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Constantin
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015331:Cohort Studies; D005260:Female; D033023:Foot Joints / Q000000981:diagnostic imaging*; D050823:Hand Joints / Q000000981:diagnostic imaging*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D011446:Prospective Studies; D011859:Radiography; D012074:Remission Induction; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents
keywords: Outcomes research; Rheumatoid Arthritis; Treatment