title: Three out of four disease-modifying anti-rheumatic drug-naïve rheumatoid arthritis patients meet 28-joint Disease Activity Score remission at 12 months: results from the FIN-ERA cohort.
abstract: OBJECTIVE
  To assess what proportion of patients with disease-modifying anti-rheumatic drug (DMARD)-naïve early rheumatoid arthritis (ERA) reach 28-joint Disease Activity Score (DAS28) remission over 1 year, and remission variability across clinics in Finland.
  
  
  METHODS
  Patients with DMARD-naïve newly diagnosed inflammatory arthritis were recruited. The proportion of patients in 28-joint Disease Activity Score with three variables (DAS28-3) remission was compared across sites. Repeated measures were analysed using a mixed models approach with appropriate distribution and link function.
  
  
  RESULTS
  In total, 611 patients were recruited at five sites: 67% were female; the mean (sd) age was 57 (16) years; 71% and 68% were positive for rheumatoid factor and anti-cyclic citrullinated peptides, respectively; and 23% had radiographic erosions. A total of 506 (83%) fulfilled the American College of Rheumatology/European League Against Rheumatism 2010 classification criteria for rheumatoid arthritis for further analyses. DAS28-3 remission was met by 68% and 75% at 3 and 12 months, respectively. The clinical site had no effect on remission when adjusted for confounders. At baseline, 68% used methotrexate-based combination therapy, and 31% used triple therapy with methotrexate, hydroxychloroquine, and sulphasalazine (the Fin-RACo regimen). In multivariate analysis, the only independent predictors of DAS28-3 remission at 12 months were lower baseline DAS28-3 and triple therapy as the initial treatment.
  
  
  CONCLUSIONS
  Three out of four DMARD-naïve ERA patients in Finland are in remission during the first year from the diagnosis. High remission rates were achieved for most patients with the use of conventional synthetic DMARDs in combination. Treatment of DMARD-naïve ERA patients with the FIN-RACo regimen is a predictor of DAS28-3 remission in real-life rheumatology settings.
authors.affiliation: a Department of Rheumatology , Central Hospital of Central Finland , Jyväskylä , Finland.
authors.forename: T
authors.initials: T
authors.lastname: Rannio
authors.affiliation: a Department of Rheumatology , Central Hospital of Central Finland , Jyväskylä , Finland.
authors.forename: J
authors.initials: J
authors.lastname: Asikainen
authors.affiliation: a Department of Rheumatology , Central Hospital of Central Finland , Jyväskylä , Finland.
authors.forename: P
authors.initials: P
authors.lastname: Hannonen
authors.affiliation: b Department of Rheumatology , Satakunta Central Hospital , Rauma , Finland.
authors.forename: T
authors.initials: T
authors.lastname: Yli-Kerttula
authors.affiliation: b Department of Rheumatology , Satakunta Central Hospital , Rauma , Finland.
authors.forename: P
authors.initials: P
authors.lastname: Ekman
authors.affiliation: c Department of Rheumatology, Internal Medicine, Department of Clinical Medicine , University of Turku , Turku , Finland.
authors.forename: L
authors.initials: L
authors.lastname: Pirilä
authors.affiliation: c Department of Rheumatology, Internal Medicine, Department of Clinical Medicine , University of Turku , Turku , Finland.
authors.forename: L
authors.initials: L
authors.lastname: Kuusalo
authors.affiliation: c Department of Rheumatology, Internal Medicine, Department of Clinical Medicine , University of Turku , Turku , Finland.
authors.forename: M
authors.initials: M
authors.lastname: Mali
authors.affiliation: c Department of Rheumatology, Internal Medicine, Department of Clinical Medicine , University of Turku , Turku , Finland.
authors.forename: M
authors.initials: M
authors.lastname: Puurtinen-Vilkki
authors.affiliation: c Department of Rheumatology, Internal Medicine, Department of Clinical Medicine , University of Turku , Turku , Finland.
authors.forename: S
authors.initials: S
authors.lastname: Kortelainen
authors.affiliation: c Department of Rheumatology, Internal Medicine, Department of Clinical Medicine , University of Turku , Turku , Finland.
authors.forename: J
authors.initials: J
authors.lastname: Paltta
authors.affiliation: c Department of Rheumatology, Internal Medicine, Department of Clinical Medicine , University of Turku , Turku , Finland.
authors.forename: K
authors.initials: K
authors.lastname: Taimen
authors.affiliation: d Department of Rheumatology , Päijät-Häme Central Hospital , Lahti , Finland.
authors.forename: M
authors.initials: M
authors.lastname: Kauppi
authors.affiliation: d Department of Rheumatology , Päijät-Häme Central Hospital , Lahti , Finland.
authors.forename: K
authors.initials: K
authors.lastname: Laiho
authors.affiliation: d Department of Rheumatology , Päijät-Häme Central Hospital , Lahti , Finland.
authors.forename: S
authors.initials: S
authors.lastname: Nyrhinen
authors.affiliation: e Department of Rheumatology , Tampere University Hospital , Tampere , Finland.
authors.forename: H
authors.initials: H
authors.lastname: Mäkinen
authors.affiliation: e Department of Rheumatology , Tampere University Hospital , Tampere , Finland.
authors.forename: P
authors.initials: P
authors.lastname: Isomäki
authors.affiliation: e Department of Rheumatology , Tampere University Hospital , Tampere , Finland.
authors.forename: T
authors.initials: T
authors.lastname: Uotila
authors.affiliation: f Faculty of Pharmacy, University of Helsinki , Helsinki , Finland.
authors.forename: K
authors.initials: K
authors.lastname: Aaltonen
authors.affiliation: g Department of General Practice and Primary Health Care , University of Helsinki , Helsinki , Finland.
authors.forename: H
authors.initials: H
authors.lastname: Kautiainen
authors.affiliation: h Faculty of Health Sciences , University of Eastern Finland , Kuopio , Finland.
authors.forename: T
authors.initials: T
authors.lastname: Sokka
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000503:physiopathology; D001688:Biological Products / Q000627:therapeutic use*; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D005387:Finland; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D015999:Multivariate Analysis; D000071066:Patient Reported Outcome Measures; D012074:Remission Induction; D012720:Severity of Illness Index; D012460:Sulfasalazine / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products; D005938:Glucocorticoids; D012460:Sulfasalazine; D006886:Hydroxychloroquine; D008727:Methotrexate