title: Early Remission Is a Realistic Target in a Majority of Patients with DMARD-naive Rheumatoid Arthritis.
abstract: OBJECTIVE
  We analyzed remission rates at 3 and 12 months in patients with rheumatoid arthritis (RA) who were naive for disease-modifying antirheumatic drugs (DMARD) and who were treated in a Finnish rheumatology clinic from 2008 to 2011. We compared remission rates and drug treatments between patients with RA and patients with undifferentiated arthritis (UA).
  
  
  METHODS
  Data from all DMARD-naive RA and UA patients from the healthcare district were collected using software that includes demographic and clinical characteristics, disease activity, medications, and patient-reported outcomes. Our rheumatology clinic applies the treat-to-target principle, electronic monitoring of patients, and multidisciplinary care.
  
  
  RESULTS
  Out of 409 patients, 406 had data for classification by the 2010 RA criteria of the American College of Rheumatology/European League Against Rheumatism. A total of 68% were female, and mean age (SD) was 58 (16) years. Respectively, 56%, 60%, and 68% were positive for anticyclic citrullinated peptide antibodies (anti-CCP), rheumatoid factor (RF), and RF/anti-CCP, and 19% had erosive disease. The median (interquartile range) duration of symptoms was 6 (4-12) months. A total of 310 were classified as RA and 96 as UA. The patients with UA were younger, had better functional status and lower disease activity, and were more often seronegative than the patients with RA. The 28-joint Disease Activity Score (3 variables) remission rates of RA and UA patients at 3 months were 67% and 58% (p = 0.13), and at 12 months, 71% and 79%, respectively (p = 0.16). Sustained remission was observed in 57%/56% of RA/UA patients. Patients with RA used more conventional synthetic DMARD combinations than did patients with UA. None used biological DMARD at 3 months, and only 2.7%/1.1% of the patients (RA/UA) used them at 12 months (p = 0.36).
  
  
  CONCLUSIONS
  Remarkably high remission rates are achievable in real-world DMARD-naive patients with RA or UA.
authors.affiliation: From the Jyväskylä Central Hospital, Jyväskylä, Finland.T. Rannio, MD, Head of Rheumatology Department; J. Asikainen, MD; A. Kokko, MD; P. Hannonen, Professor Emeritus of Rheumatology; T. Sokka, Professor of Rheumatology, Jyväskylä Central Hospital. tuomas.rannio@ksshp.fi.
authors.forename: Tuomas
authors.initials: T
authors.lastname: Rannio
authors.affiliation: From the Jyväskylä Central Hospital, Jyväskylä, Finland.T. Rannio, MD, Head of Rheumatology Department; J. Asikainen, MD; A. Kokko, MD; P. Hannonen, Professor Emeritus of Rheumatology; T. Sokka, Professor of Rheumatology, Jyväskylä Central Hospital.
authors.forename: Juha
authors.initials: J
authors.lastname: Asikainen
authors.affiliation: From the Jyväskylä Central Hospital, Jyväskylä, Finland.T. Rannio, MD, Head of Rheumatology Department; J. Asikainen, MD; A. Kokko, MD; P. Hannonen, Professor Emeritus of Rheumatology; T. Sokka, Professor of Rheumatology, Jyväskylä Central Hospital.
authors.forename: Arto
authors.initials: A
authors.lastname: Kokko
authors.affiliation: From the Jyväskylä Central Hospital, Jyväskylä, Finland.T. Rannio, MD, Head of Rheumatology Department; J. Asikainen, MD; A. Kokko, MD; P. Hannonen, Professor Emeritus of Rheumatology; T. Sokka, Professor of Rheumatology, Jyväskylä Central Hospital.
authors.forename: Pekka
authors.initials: P
authors.lastname: Hannonen
authors.affiliation: From the Jyväskylä Central Hospital, Jyväskylä, Finland.T. Rannio, MD, Head of Rheumatology Department; J. Asikainen, MD; A. Kokko, MD; P. Hannonen, Professor Emeritus of Rheumatology; T. Sokka, Professor of Rheumatology, Jyväskylä Central Hospital.
authors.forename: Tuulikki
authors.initials: T
authors.lastname: Sokka
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D001323:Autoantibodies / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000276:immunology; D012074:Remission Induction / Q000379:methods*; D012217:Rheumatoid Factor / Q000097:blood; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D001323:Autoantibodies; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide; D012217:Rheumatoid Factor
keywords: CLINICAL MONITORING; DISEASE ACTIVITY; OUTCOMES; RHEUMATOID ARTHRITIS