title: [Clinical remission in rheumatoid arthritis. Data from the early arthritis cohort study CAPEA].
abstract: OBJECTIVE
  To evaluate remission rates and therapeutic strategies in the routine care of early rheumatoid arthritis.
  
  
  METHODS
  Between 2010 and 2013, a total of 1,301 patients with early arthritis were followed by 89 rheumatologists for up to 2 years in an early arthritis cohort (CAPEA). Complete 2-year data are available for 669 patients with rheumatoid arthritis.
  
  
  RESULTS
  Ninety-three percent of patients were diagnosed with a moderate or high disease activity score (DAS28 > 3.2). Within 6 months, 40 % were in clinical remission (DAS28 < 2.6) and 21 % reached a low disease activity score (DAS28 > 2.6 to < 3.2). This proportion did not substantially increase during the 2-year follow-up. Methotrexate was the standard first-line treatment in 82 % of patients. During follow-up, 10 % were treated with a combination of disease-modifying antirheumatic drugs (DMARDs) and 12 % with biological agents. In 60 % of the patients who did not reach remission within 3 months (and 54 % of patients without remission by 6 months), treatment was not changed. At the beginning, 77 % of patients were treated with glucocorticoids at different starting doses (26 % < 7.5 mg, 29 % 7.5-20 mg, and 45 % ≥ 20 mg of prednisolone per day). After 2 years, 47 % remained on glucocorticoids.
  
  
  CONCLUSIONS
  While 40 % of patients achieved clinical remission through standard care within 6 months, disease activity remained moderate to high in 37 % of patients at 2 years. In these patients a more consistent application of treatment may have increased the response rates.
authors.affiliation: Deutsches Rheuma-Forschungszentrum Berlin, Charitéplatz 1, 10117, Berlin, Deutschland. albrecht@drfz.de.
authors.forename: K
authors.initials: K
authors.lastname: Albrecht
authors.affiliation: Deutsches Rheuma-Forschungszentrum Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
authors.forename: J
authors.initials: J
authors.lastname: Callhoff
authors.affiliation: Rheumapraxis Bad Aibling, Bad Aibling, Deutschland.
authors.forename: E
authors.initials: E
authors.lastname: Edelmann
authors.affiliation: Medizinische Klinik 3, Universitätsklinikum Erlangen, Erlangen, Deutschland.
authors.forename: G
authors.initials: G
authors.lastname: Schett
authors.affiliation: Poliklinik und Hiller Forschungszentrum für Rheumatologie, Heinrich-Heine Universität Düsseldorf, Düsseldorf, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Schneider
authors.affiliation: Deutsches Rheuma-Forschungszentrum Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Zink
mesh_terms: D018501:Antirheumatic Agents / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D015331:Cohort Studies; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage*; D008875:Middle Aged; D015995:Prevalence; D012074:Remission Induction / Q000379:methods; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D005938:Glucocorticoids; D008727:Methotrexate
keywords: Antirheumatic agents; Combination drug therapy; Glucocorticoids; Prognosis; Treatment outcome