title: Remission is related to CRP and smoking in early axial spondyloarthritis. The DESIR cohort.
abstract: BACKGROUND
  No evaluation of factors associated with remission has been performed in early SpA. The aim of the study was to evaluate percentage of patients in remission using and comparing different definitions of remission, and to evaluate factors associated with remission at inclusion in the prospective DESIR cohort, and after 24 months.
  
  
  METHODS
  Performance of three definitions (ASAS partial remission [PR], ASDAS-CRP less than 1.3 [ASDAS-R], BASDAI less than 3.6 [BASDAI-R]) were assessed using sensibility, specificity and Youden Index. Data at M0 and M24 were analyzed in uni- and multivariate analysis.
  
  
  RESULTS
  Seven hundred and six patients were evaluated at M0 and 577 at M24. At M0, percentage of patients in remission was 4% (PR), 8% (ASDAS), 34% (BASDAI), and at M24: 15%, 24% and 54% respectively, in the whole population and similar in Amor, ESSG and ASAS classified patients. BASDAI less than 3.6 had the best sensitivity, and ASDAS-R the best Youden index when using each of the two other definitions of remission as a gold standard. At M24 in multivariate analysis, remission was associated with less smoking, less analgesics, ASAS clinical arm fulfilling, less NSAIDs (ASDAS-R), low CRP (ASDAS-R), low BMI (BASDAI-R). However, over the two years, this study did not allow to demonstrate a relation between remission and structural progression or morbidity.
  
  
  CONCLUSIONS
  In this population suggestive of early SpA, smoking and CRP appear as major markers of disease activity in early SpA, and associated with absence of remission.
authors.affiliation: Department of Rheumatology, CHRU de Besançon, University Teaching Hospital, Boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, 25030 Besançon, France. Electronic address: dwendling@chu-besancon.fr.
authors.forename: Daniel
authors.initials: D
authors.lastname: Wendling
authors.affiliation: Department of Rheumatology, CHRU de Besançon, University Teaching Hospital, Boulevard Fleming, 25030 Besançon, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Guillot
authors.affiliation: Sorbonne Universités, UPMC Université Paris 06, Institut Pierre-Louis d'Épidémiologie et de Santé Publique, GRC-UPMC 08 (EEMOIS), 75013 Paris, France; AP-HP, Pitié-Salpêtrière Hospital, Department of Rheumatology, 75013 Paris, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Gossec
authors.affiliation: Department of Rheumatology, CHRU de Besançon, University Teaching Hospital, Boulevard Fleming, 25030 Besançon, France; Université de Franche-Comté, 25030 Besançon, France.
authors.forename: Clément
authors.initials: C
authors.lastname: Prati
authors.affiliation: Service de rhumatologie, CHU de Brest, 29609 Brest cedex, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Saraux
authors.affiliation: Université Paris Descartes, Service de rhumatologie, Hôpital Cochin, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; INSERM (U1153): Épidémiologie clinique et biostatistique, PRES Sorbonne Paris-Cité, 109, avenue de France, 75013 Paris, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Dougados
mesh_terms: D000328:Adult; D001416:Back Pain / Q000453:epidemiology / Q000209:etiology*; D002097:C-Reactive Protein / Q000032:analysis; D018450:Disease Progression; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012074:Remission Induction; D012075:Remission, Spontaneous; D012907:Smoking / Q000009:adverse effects*; D025241:Spondylarthritis / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology
chemical_list: D002097:C-Reactive Protein
keywords: Early disease; Remission; Spondyloarthritis