title: Longitudinal study of clinical prognostic factors in patients with early rheumatoid arthritis: the PREDICT study.
abstract: OBJECTIVE
  To assess the association between baseline clinical prognostic factors and subsequent Disease Activity Score of 28 joints (DAS28) remission in early rheumatoid arthritis (RA).
  
  
  METHODS
  Data were collected using point of care clinical software from participating rheumatology centres. Patients aged 18 years or over whose date of clinical onset of RA was within the previous 12-24 months, who had at least 6 months of follow-up data and a DAS28-ESR (erythrocyte sedimentation rate) score recorded between 12 and 24 months from first being seen for RA were included. Data collected included baseline demographics, mode of disease onset, pattern of joint involvement at onset, smoking status, DAS28, rheumatoid factor (RF), anti-citrullinated peptide antibodies (ACPA), time from symptom onset to presentation and disease activity at baseline. Univariate and multivariate logistic regression of DAS28-ESR remission between 12 and 24 months after first assessment were performed.
  
  
  RESULTS
  Data from 1017 patients were analyzed: 70% female; mean age 60 years (SD: 14.7); 70% RF-positive, 58% ACPA-positive. The strongest age and sex adjusted baseline predictors of DAS28-ESR remission at 12-24 months were remission at baseline (odds ratio [OR]: 4.49, 95% CI: 2.17-9.29, P < 0.001), being male (OR: 2.42, 95% CI: 1.46-4.01, P < 0.001), abstaining from alcohol (P < 0.001) and being lower weight (OR: 0.98, 95% CI: 0.97-1.00, P = 0.015). There was no statistically significant association between joint onset patterns, mode of onset, RF, ACPA or smoking status.
  
  
  CONCLUSIONS
  In this observational study, patients with early RA at risk of not achieving remission include those with high disease activity at baseline, women, those who drink alcohol and those with higher body weight.
authors.affiliation: University of New South Wales and Combined Rheumatology Practice, Kogarah, New South Wales, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Bird
authors.affiliation: Coast Joint Care, Maroochydore, Queensland, Australia.
authors.forename: Dave
authors.initials: D
authors.lastname: Nicholls
authors.affiliation: Roche Products, Pty. Limited, Sydney, New South Wales, Australia.
authors.forename: Rina
authors.initials: R
authors.lastname: Barrett
authors.affiliation: Olser House, Southport, Queensland, Australia.
authors.forename: Julien
authors.initials: J
authors.lastname: de Jager
authors.affiliation: Barwon Rheumatology Service, Geelong, Victoria, Australia.
authors.forename: Hedley
authors.initials: H
authors.lastname: Griffiths
authors.affiliation: Monash Medical Centre, Melbourne, Victoria, Australia.
authors.forename: Lynden
authors.initials: L
authors.lastname: Roberts
authors.affiliation: Canberra Rheumatology, Canberra, Australian Capital Territory, Australia.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Tymms
authors.affiliation: McCloud Consulting Group, Sydney, New South Wales, Australia.
authors.forename: Philip
authors.initials: P
authors.lastname: McCloud
authors.affiliation: Monash Medical Centre, Melbourne, Victoria, Australia.|Monash University, Melbourne, Victoria, Australia.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Littlejohn
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D000075422:Anti-Citrullinated Protein Antibodies / Q000097:blood; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D001315:Australia; D015415:Biomarkers / Q000097:blood; D001799:Blood Sedimentation; D001835:Body Weight; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007596:Joints / Q000187:drug effects / Q000473:pathology*; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D019095:Point-of-Care Systems; D000067716:Point-of-Care Testing; D011237:Predictive Value of Tests; D012042:Registries; D012074:Remission Induction; D012217:Rheumatoid Factor / Q000097:blood; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000075422:Anti-Citrullinated Protein Antibodies; D018501:Antirheumatic Agents; D015415:Biomarkers; D012217:Rheumatoid Factor
keywords: prognostic factors; remission; rheumatoid arthritis; rheumatoid factor