title: Earlier time to remission predicts sustained clinical remission in early rheumatoid arthritis--results from the Canadian Early Arthritis Cohort (CATCH).
abstract: OBJECTIVE
  To evaluate the prevalence and predictive factors of sustained remission in an early rheumatoid arthritis (ERA) population. Predictive factors of sustained remission in ERA are unknown. We hypothesized that a short time to remission is an important predictor of sustained clinical remission.
  
  
  METHODS
  Patients in the Canadian Early Arthritis Cohort were included. Remission was defined by Boolean-based American College of Rheumatology/European League Against Rheumatism clinical trial and clinical practice definitions and Simplified Disease Activity Index (SDAI). Logistic regression analysis identified predictors of sustained remission and influence of time to remission.
  
  
  RESULTS
  Of 1840 patients, 633 (34%) achieved clinical trial remission, 759 (41%) clinical practice remission, and 727 (39%) SDAI remission. Over half of those meeting remission criteria achieved sustained remission based on clinical trial (55%), clinical practice (60%), and/or SDAI (58%). Corticosteroid use and lack of initial disease-modifying antirheumatic drug (DMARD) were associated with decreased probability of sustained remission, while initial combination DMARD increased this probability. Female sex, greater pain, and longer time to first remission made sustained remission less likely.
  
  
  CONCLUSIONS
  Female sex, greater pain, and lack of initial DMARD therapy reduced the probability of sustained remission. A shorter time to remission is related to sustainability and supports striving for early remission.
authors.affiliation: From the Rheumatology Department, Mount Sinai Hospital, University of Toronto, Toronto, Ontario; Université de Sherbrooke, Sherbrooke; Rheumatic Disease Unit, Institut de Rhumatologie, Montreal, Quebec; Arthritis Centre, University of Manitoba, Winnipeg, Manitoba; Rheumatology Department, St. Joseph's Health Care, Western University, London; Southlake Regional Health Centre, Newmarket, Ontario, Canada; Hospital for Special Surgery, Cornell University, New York, New York, USA.B. Kuriya, MD, MS, FRCPC; J. Xiong, MSc, PhD, Rheumatology Department, Mount Sinai Hospital, University of Toronto; G. Boire, MD, MSc, FRCPC, Université de Sherbrooke; B. Haraoui, MD, FRCPC, Rheumatic Disease Unit, Institut de Rhumatologie; C. Hitchon, MD, MSc, FRCPC, Arthritis Centre, University of Manitoba; J. Pope, MD, MPH, FRCPC, Rheumatology Department, St. Joseph's Health Care, Western University; J.C. Thorne, MD, FRCP, FACP; D. Tin, BSc PHm, RPh, CDE, CGP, Southlake Regional Health Centre; E.C. Keystone, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto; V. Bykerk, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto, and Hospital for Special Surgery, Cornell University. bkuriya@mtsinai.on.ca.
authors.forename: Bindee
authors.initials: B
authors.lastname: Kuriya
authors.affiliation: From the Rheumatology Department, Mount Sinai Hospital, University of Toronto, Toronto, Ontario; Université de Sherbrooke, Sherbrooke; Rheumatic Disease Unit, Institut de Rhumatologie, Montreal, Quebec; Arthritis Centre, University of Manitoba, Winnipeg, Manitoba; Rheumatology Department, St. Joseph's Health Care, Western University, London; Southlake Regional Health Centre, Newmarket, Ontario, Canada; Hospital for Special Surgery, Cornell University, New York, New York, USA.B. Kuriya, MD, MS, FRCPC; J. Xiong, MSc, PhD, Rheumatology Department, Mount Sinai Hospital, University of Toronto; G. Boire, MD, MSc, FRCPC, Université de Sherbrooke; B. Haraoui, MD, FRCPC, Rheumatic Disease Unit, Institut de Rhumatologie; C. Hitchon, MD, MSc, FRCPC, Arthritis Centre, University of Manitoba; J. Pope, MD, MPH, FRCPC, Rheumatology Department, St. Joseph's Health Care, Western University; J.C. Thorne, MD, FRCP, FACP; D. Tin, BSc PHm, RPh, CDE, CGP, Southlake Regional Health Centre; E.C. Keystone, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto; V. Bykerk, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto, and Hospital for Special Surgery, Cornell University.
authors.forename: Juan
authors.initials: J
authors.lastname: Xiong
authors.affiliation: From the Rheumatology Department, Mount Sinai Hospital, University of Toronto, Toronto, Ontario; Université de Sherbrooke, Sherbrooke; Rheumatic Disease Unit, Institut de Rhumatologie, Montreal, Quebec; Arthritis Centre, University of Manitoba, Winnipeg, Manitoba; Rheumatology Department, St. Joseph's Health Care, Western University, London; Southlake Regional Health Centre, Newmarket, Ontario, Canada; Hospital for Special Surgery, Cornell University, New York, New York, USA.B. Kuriya, MD, MS, FRCPC; J. Xiong, MSc, PhD, Rheumatology Department, Mount Sinai Hospital, University of Toronto; G. Boire, MD, MSc, FRCPC, Université de Sherbrooke; B. Haraoui, MD, FRCPC, Rheumatic Disease Unit, Institut de Rhumatologie; C. Hitchon, MD, MSc, FRCPC, Arthritis Centre, University of Manitoba; J. Pope, MD, MPH, FRCPC, Rheumatology Department, St. Joseph's Health Care, Western University; J.C. Thorne, MD, FRCP, FACP; D. Tin, BSc PHm, RPh, CDE, CGP, Southlake Regional Health Centre; E.C. Keystone, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto; V. Bykerk, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto, and Hospital for Special Surgery, Cornell University.
authors.forename: Gilles
authors.initials: G
authors.lastname: Boire
authors.affiliation: From the Rheumatology Department, Mount Sinai Hospital, University of Toronto, Toronto, Ontario; Université de Sherbrooke, Sherbrooke; Rheumatic Disease Unit, Institut de Rhumatologie, Montreal, Quebec; Arthritis Centre, University of Manitoba, Winnipeg, Manitoba; Rheumatology Department, St. Joseph's Health Care, Western University, London; Southlake Regional Health Centre, Newmarket, Ontario, Canada; Hospital for Special Surgery, Cornell University, New York, New York, USA.B. Kuriya, MD, MS, FRCPC; J. Xiong, MSc, PhD, Rheumatology Department, Mount Sinai Hospital, University of Toronto; G. Boire, MD, MSc, FRCPC, Université de Sherbrooke; B. Haraoui, MD, FRCPC, Rheumatic Disease Unit, Institut de Rhumatologie; C. Hitchon, MD, MSc, FRCPC, Arthritis Centre, University of Manitoba; J. Pope, MD, MPH, FRCPC, Rheumatology Department, St. Joseph's Health Care, Western University; J.C. Thorne, MD, FRCP, FACP; D. Tin, BSc PHm, RPh, CDE, CGP, Southlake Regional Health Centre; E.C. Keystone, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto; V. Bykerk, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto, and Hospital for Special Surgery, Cornell University.
authors.forename: Boulos
authors.initials: B
authors.lastname: Haraoui
authors.affiliation: From the Rheumatology Department, Mount Sinai Hospital, University of Toronto, Toronto, Ontario; Université de Sherbrooke, Sherbrooke; Rheumatic Disease Unit, Institut de Rhumatologie, Montreal, Quebec; Arthritis Centre, University of Manitoba, Winnipeg, Manitoba; Rheumatology Department, St. Joseph's Health Care, Western University, London; Southlake Regional Health Centre, Newmarket, Ontario, Canada; Hospital for Special Surgery, Cornell University, New York, New York, USA.B. Kuriya, MD, MS, FRCPC; J. Xiong, MSc, PhD, Rheumatology Department, Mount Sinai Hospital, University of Toronto; G. Boire, MD, MSc, FRCPC, Université de Sherbrooke; B. Haraoui, MD, FRCPC, Rheumatic Disease Unit, Institut de Rhumatologie; C. Hitchon, MD, MSc, FRCPC, Arthritis Centre, University of Manitoba; J. Pope, MD, MPH, FRCPC, Rheumatology Department, St. Joseph's Health Care, Western University; J.C. Thorne, MD, FRCP, FACP; D. Tin, BSc PHm, RPh, CDE, CGP, Southlake Regional Health Centre; E.C. Keystone, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto; V. Bykerk, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto, and Hospital for Special Surgery, Cornell University.
authors.forename: Carol
authors.initials: C
authors.lastname: Hitchon
authors.affiliation: From the Rheumatology Department, Mount Sinai Hospital, University of Toronto, Toronto, Ontario; Université de Sherbrooke, Sherbrooke; Rheumatic Disease Unit, Institut de Rhumatologie, Montreal, Quebec; Arthritis Centre, University of Manitoba, Winnipeg, Manitoba; Rheumatology Department, St. Joseph's Health Care, Western University, London; Southlake Regional Health Centre, Newmarket, Ontario, Canada; Hospital for Special Surgery, Cornell University, New York, New York, USA.B. Kuriya, MD, MS, FRCPC; J. Xiong, MSc, PhD, Rheumatology Department, Mount Sinai Hospital, University of Toronto; G. Boire, MD, MSc, FRCPC, Université de Sherbrooke; B. Haraoui, MD, FRCPC, Rheumatic Disease Unit, Institut de Rhumatologie; C. Hitchon, MD, MSc, FRCPC, Arthritis Centre, University of Manitoba; J. Pope, MD, MPH, FRCPC, Rheumatology Department, St. Joseph's Health Care, Western University; J.C. Thorne, MD, FRCP, FACP; D. Tin, BSc PHm, RPh, CDE, CGP, Southlake Regional Health Centre; E.C. Keystone, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto; V. Bykerk, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto, and Hospital for Special Surgery, Cornell University.
authors.forename: Janet
authors.initials: J
authors.lastname: Pope
authors.affiliation: From the Rheumatology Department, Mount Sinai Hospital, University of Toronto, Toronto, Ontario; Université de Sherbrooke, Sherbrooke; Rheumatic Disease Unit, Institut de Rhumatologie, Montreal, Quebec; Arthritis Centre, University of Manitoba, Winnipeg, Manitoba; Rheumatology Department, St. Joseph's Health Care, Western University, London; Southlake Regional Health Centre, Newmarket, Ontario, Canada; Hospital for Special Surgery, Cornell University, New York, New York, USA.B. Kuriya, MD, MS, FRCPC; J. Xiong, MSc, PhD, Rheumatology Department, Mount Sinai Hospital, University of Toronto; G. Boire, MD, MSc, FRCPC, Université de Sherbrooke; B. Haraoui, MD, FRCPC, Rheumatic Disease Unit, Institut de Rhumatologie; C. Hitchon, MD, MSc, FRCPC, Arthritis Centre, University of Manitoba; J. Pope, MD, MPH, FRCPC, Rheumatology Department, St. Joseph's Health Care, Western University; J.C. Thorne, MD, FRCP, FACP; D. Tin, BSc PHm, RPh, CDE, CGP, Southlake Regional Health Centre; E.C. Keystone, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto; V. Bykerk, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto, and Hospital for Special Surgery, Cornell University.
authors.forename: John Carter
authors.initials: JC
authors.lastname: Thorne
authors.affiliation: From the Rheumatology Department, Mount Sinai Hospital, University of Toronto, Toronto, Ontario; Université de Sherbrooke, Sherbrooke; Rheumatic Disease Unit, Institut de Rhumatologie, Montreal, Quebec; Arthritis Centre, University of Manitoba, Winnipeg, Manitoba; Rheumatology Department, St. Joseph's Health Care, Western University, London; Southlake Regional Health Centre, Newmarket, Ontario, Canada; Hospital for Special Surgery, Cornell University, New York, New York, USA.B. Kuriya, MD, MS, FRCPC; J. Xiong, MSc, PhD, Rheumatology Department, Mount Sinai Hospital, University of Toronto; G. Boire, MD, MSc, FRCPC, Université de Sherbrooke; B. Haraoui, MD, FRCPC, Rheumatic Disease Unit, Institut de Rhumatologie; C. Hitchon, MD, MSc, FRCPC, Arthritis Centre, University of Manitoba; J. Pope, MD, MPH, FRCPC, Rheumatology Department, St. Joseph's Health Care, Western University; J.C. Thorne, MD, FRCP, FACP; D. Tin, BSc PHm, RPh, CDE, CGP, Southlake Regional Health Centre; E.C. Keystone, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto; V. Bykerk, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto, and Hospital for Special Surgery, Cornell University.
authors.forename: Diane
authors.initials: D
authors.lastname: Tin
authors.affiliation: From the Rheumatology Department, Mount Sinai Hospital, University of Toronto, Toronto, Ontario; Université de Sherbrooke, Sherbrooke; Rheumatic Disease Unit, Institut de Rhumatologie, Montreal, Quebec; Arthritis Centre, University of Manitoba, Winnipeg, Manitoba; Rheumatology Department, St. Joseph's Health Care, Western University, London; Southlake Regional Health Centre, Newmarket, Ontario, Canada; Hospital for Special Surgery, Cornell University, New York, New York, USA.B. Kuriya, MD, MS, FRCPC; J. Xiong, MSc, PhD, Rheumatology Department, Mount Sinai Hospital, University of Toronto; G. Boire, MD, MSc, FRCPC, Université de Sherbrooke; B. Haraoui, MD, FRCPC, Rheumatic Disease Unit, Institut de Rhumatologie; C. Hitchon, MD, MSc, FRCPC, Arthritis Centre, University of Manitoba; J. Pope, MD, MPH, FRCPC, Rheumatology Department, St. Joseph's Health Care, Western University; J.C. Thorne, MD, FRCP, FACP; D. Tin, BSc PHm, RPh, CDE, CGP, Southlake Regional Health Centre; E.C. Keystone, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto; V. Bykerk, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto, and Hospital for Special Surgery, Cornell University.
authors.forename: Edward C
authors.initials: EC
authors.lastname: Keystone
authors.affiliation: From the Rheumatology Department, Mount Sinai Hospital, University of Toronto, Toronto, Ontario; Université de Sherbrooke, Sherbrooke; Rheumatic Disease Unit, Institut de Rhumatologie, Montreal, Quebec; Arthritis Centre, University of Manitoba, Winnipeg, Manitoba; Rheumatology Department, St. Joseph's Health Care, Western University, London; Southlake Regional Health Centre, Newmarket, Ontario, Canada; Hospital for Special Surgery, Cornell University, New York, New York, USA.B. Kuriya, MD, MS, FRCPC; J. Xiong, MSc, PhD, Rheumatology Department, Mount Sinai Hospital, University of Toronto; G. Boire, MD, MSc, FRCPC, Université de Sherbrooke; B. Haraoui, MD, FRCPC, Rheumatic Disease Unit, Institut de Rhumatologie; C. Hitchon, MD, MSc, FRCPC, Arthritis Centre, University of Manitoba; J. Pope, MD, MPH, FRCPC, Rheumatology Department, St. Joseph's Health Care, Western University; J.C. Thorne, MD, FRCP, FACP; D. Tin, BSc PHm, RPh, CDE, CGP, Southlake Regional Health Centre; E.C. Keystone, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto; V. Bykerk, MD, FRCPC, Rheumatology Department, Mount Sinai Hospital, University of Toronto, and Hospital for Special Surgery, Cornell University.
authors.forename: Vivian
authors.initials: V
authors.lastname: Bykerk
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000188:drug therapy*; D002170:Canada; D015331:Cohort Studies; D016208:Databases, Factual; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010147:Pain Measurement; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology*; D012074:Remission Induction; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents
keywords: DISEASE-MODIFYING ANTIRHEUMATIC DRUGS; OUTCOMES; REMISSION; RHEUMATOID ARTHRITIS