title: Continual Maintenance of Remission Defined by the ACR/EULAR Criteria in Daily Practice Leads to Better Functional Outcomes in Patients with Rheumatoid Arthritis.
abstract: To evaluate longterm functional outcomes in rheumatoid arthritis (RA) based on the number of times that the American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) or the 28-joint Disease Activity Score (DAS28) remission criteria were fulfilled.
  
  
  
  Patients with RA who participated in all 6 data collections in an observational cohort from 2008 to 2010 and who fulfilled the DAS28 remission criteria at baseline were studied. Patients were classified by the number of times they fulfilled the ACR/EULAR [Boolean trial, Boolean practice, Simplified Disease Activity Index (SDAI), or Clinical Disease Activity Index (CDAI)] or DAS28 remission criteria at each collection. The OR for the Japanese version of the Health Assessment Questionnaire (J-HAQ) progression, based on the number of times each set of remission criteria was fulfilled, were calculated by logistic regression.
  
  
  
  A total of 915 patients were studied. The OR (95% CI) for J-HAQ progression were 0.54 (0.33-0.87), 0.55 (0.33-0.92), 0.48 (0.28-0.82), 0.29 (0.16-0.51), 0.24 (0.13-0.47), and 0.07 (0.03-0.15) for those fulfilling the Boolean trial remission from 1 to 6 times. This tendency was also observed for the other 4 criteria. The OR (95% CI) for J-HAQ progression in patients who achieved remission at all 6 data collections were 0.07 (0.03-0.14) for the Boolean practice, 0.10 (0.05-0.20) for the SDAI, and 0.07 (0.04-0.15) for the CDAI, whereas 0.15 (0.08-0.29) for the DAS28.
  
  
  
  Continual fulfillment of any remission criteria was strongly effective in preventing patients from progression of functional disability; however, the ACR/EULAR criteria appear to be preferable.
authors.affiliation: From the Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan.|H. Yamanaka has received research grants from Astellas Pharma Inc. and Bristol-Myers-Squibb.|K.S. Shidara, MD, PhD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; A.N. Nakajima, MD, PhD, Associate Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.I. Inoue, PhD, Institute of Rheumatology, Tokyo Women's Medical University; D.H. Hoshi, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; N.S. Sugimoto, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; Y.S. Seto, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.T. Tanaka, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; S.M. Momohara, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; A.T. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H.Y. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University.
authors.forename: Kumi
authors.initials: K
authors.lastname: Shidara
authors.affiliation: From the Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan. ayakonkj@twmu.ac.jp.|H. Yamanaka has received research grants from Astellas Pharma Inc. and Bristol-Myers-Squibb. ayakonkj@twmu.ac.jp.|K.S. Shidara, MD, PhD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; A.N. Nakajima, MD, PhD, Associate Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.I. Inoue, PhD, Institute of Rheumatology, Tokyo Women's Medical University; D.H. Hoshi, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; N.S. Sugimoto, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; Y.S. Seto, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.T. Tanaka, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; S.M. Momohara, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; A.T. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H.Y. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University. ayakonkj@twmu.ac.jp.
authors.forename: Ayako
authors.initials: A
authors.lastname: Nakajima
authors.affiliation: From the Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan.|H. Yamanaka has received research grants from Astellas Pharma Inc. and Bristol-Myers-Squibb.|K.S. Shidara, MD, PhD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; A.N. Nakajima, MD, PhD, Associate Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.I. Inoue, PhD, Institute of Rheumatology, Tokyo Women's Medical University; D.H. Hoshi, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; N.S. Sugimoto, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; Y.S. Seto, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.T. Tanaka, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; S.M. Momohara, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; A.T. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H.Y. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University.
authors.forename: Eisuke
authors.initials: E
authors.lastname: Inoue
authors.affiliation: From the Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan.|H. Yamanaka has received research grants from Astellas Pharma Inc. and Bristol-Myers-Squibb.|K.S. Shidara, MD, PhD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; A.N. Nakajima, MD, PhD, Associate Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.I. Inoue, PhD, Institute of Rheumatology, Tokyo Women's Medical University; D.H. Hoshi, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; N.S. Sugimoto, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; Y.S. Seto, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.T. Tanaka, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; S.M. Momohara, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; A.T. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H.Y. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hoshi
authors.affiliation: From the Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan.|H. Yamanaka has received research grants from Astellas Pharma Inc. and Bristol-Myers-Squibb.|K.S. Shidara, MD, PhD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; A.N. Nakajima, MD, PhD, Associate Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.I. Inoue, PhD, Institute of Rheumatology, Tokyo Women's Medical University; D.H. Hoshi, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; N.S. Sugimoto, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; Y.S. Seto, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.T. Tanaka, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; S.M. Momohara, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; A.T. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H.Y. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University.
authors.forename: Naoki
authors.initials: N
authors.lastname: Sugimoto
authors.affiliation: From the Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan.|H. Yamanaka has received research grants from Astellas Pharma Inc. and Bristol-Myers-Squibb.|K.S. Shidara, MD, PhD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; A.N. Nakajima, MD, PhD, Associate Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.I. Inoue, PhD, Institute of Rheumatology, Tokyo Women's Medical University; D.H. Hoshi, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; N.S. Sugimoto, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; Y.S. Seto, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.T. Tanaka, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; S.M. Momohara, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; A.T. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H.Y. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Seto
authors.affiliation: From the Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan.|H. Yamanaka has received research grants from Astellas Pharma Inc. and Bristol-Myers-Squibb.|K.S. Shidara, MD, PhD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; A.N. Nakajima, MD, PhD, Associate Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.I. Inoue, PhD, Institute of Rheumatology, Tokyo Women's Medical University; D.H. Hoshi, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; N.S. Sugimoto, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; Y.S. Seto, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.T. Tanaka, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; S.M. Momohara, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; A.T. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H.Y. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University.
authors.forename: Eiichi
authors.initials: E
authors.lastname: Tanaka
authors.affiliation: From the Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan.|H. Yamanaka has received research grants from Astellas Pharma Inc. and Bristol-Myers-Squibb.|K.S. Shidara, MD, PhD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; A.N. Nakajima, MD, PhD, Associate Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.I. Inoue, PhD, Institute of Rheumatology, Tokyo Women's Medical University; D.H. Hoshi, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; N.S. Sugimoto, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; Y.S. Seto, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.T. Tanaka, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; S.M. Momohara, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; A.T. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H.Y. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Momohara
authors.affiliation: From the Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan.|H. Yamanaka has received research grants from Astellas Pharma Inc. and Bristol-Myers-Squibb.|K.S. Shidara, MD, PhD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; A.N. Nakajima, MD, PhD, Associate Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.I. Inoue, PhD, Institute of Rheumatology, Tokyo Women's Medical University; D.H. Hoshi, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; N.S. Sugimoto, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; Y.S. Seto, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.T. Tanaka, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; S.M. Momohara, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; A.T. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H.Y. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University.
authors.forename: Atsuo
authors.initials: A
authors.lastname: Taniguchi
authors.affiliation: From the Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan.|H. Yamanaka has received research grants from Astellas Pharma Inc. and Bristol-Myers-Squibb.|K.S. Shidara, MD, PhD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; A.N. Nakajima, MD, PhD, Associate Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.I. Inoue, PhD, Institute of Rheumatology, Tokyo Women's Medical University; D.H. Hoshi, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; N.S. Sugimoto, MD, Instructor, Institute of Rheumatology, Tokyo Women's Medical University; Y.S. Seto, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; E.T. Tanaka, MD, PhD, Assistant Professor, Institute of Rheumatology, Tokyo Women's Medical University; S.M. Momohara, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; A.T. Taniguchi, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University; H.Y. Yamanaka, MD, PhD, Professor, Institute of Rheumatology, Tokyo Women's Medical University.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Yamanaka
mesh_terms: D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000188:drug therapy; D016208:Databases, Factual; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents
keywords: DISEASE ACTIVITY; FUNCTIONAL DISABILITY; REMISSION CRITERIA; RHEUMATOID ARTHRITIS