Patient-reported outcomes as predictors of remission in early rheumatoid arthritis patients treated with tight control treat-to-target approach

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Kuusalo , L , Puolakka , K , Kautiainen , H , Karjalainen , A , Malmi , T , Yli-Kerttula , T , Leirisalo-Repo , M , Rantalaiho , V & NEO-RACo Study Grp 2017 , ' Patient-reported outcomes as predictors of remission in early rheumatoid arthritis patients treated with tight control treat-to-target approach ' , Rheumatology International , vol. 37 , no. 5 , pp. 825-830 . https://doi.org/10.1007/s00296-017-3692-7

Title: Patient-reported outcomes as predictors of remission in early rheumatoid arthritis patients treated with tight control treat-to-target approach
Author: Kuusalo, Laura; Puolakka, Kari; Kautiainen, Hannu; Karjalainen, Anna; Malmi, Timo; Yli-Kerttula, Timo; Leirisalo-Repo, Marjatta; Rantalaiho, Vappu; NEO-RACo Study Grp
Contributor: University of Helsinki, HYKS erva
University of Helsinki, Department of General Practice and Primary Health Care
University of Helsinki, Clinicum
Date: 2017-05
Language: eng
Number of pages: 6
Belongs to series: Rheumatology International
ISSN: 0172-8172
URI: http://hdl.handle.net/10138/236946
Abstract: Identifying prognostic factors for remission in early rheumatoid arthritis (ERA) patients is of key clinical importance. We studied patient-reported outcomes (PROs) as predictors of remission in a clinical trial. We randomized 99 untreated ERA patients to receive remission-targeted treatment with three disease-modifying antirheumatic drugs and prednisolone for 24 months, and infliximab or placebo for the initial 6 months. At baseline, we measured following PROs: eight Short Form 36 questionnaire (SF-36) dimensions, patient's global assessment [PGA, visual analogue scale (VAS)], Health Assessment Questionnaire (HAQ), and pain VAS. We used multivariable-adjusted regression models to identify PROs that independently predicted modified American College of Rheumatology remission at 2 years. Follow-up data at 2 years were available for 93 patients (92%), and 58 patients (62%) were in remission. At baseline, patients who achieved remission had higher radiological score (p = 0.04), lower tender joint count (p = 0.001), lower PGA (p = 0.005) and physician's global assessment (p = 0.019), lower HAQ (p = 0.016), less morning stiffness (p = 0.009), and significantly higher scores in seven out of eight SF-36 dimensions compared with patients who did not. In multivariable models that included all PROs, remission was associated with SF-36 dimensions higher vitality (odds ratio 2.01; 95% confidence interval 1.19-3.39) and better emotional role functioning (odds ratio 1.64; 95% confidence interval 1.01-2.68). PGA, pain VAS, HAQ, and other SF-36 dimensions were not associated with remission. We conclude that self-reported vitality and better emotional role functioning are among the most important PROs for the prediction of remission in ERA.
Subject: Rheumatoid arthritis
Clinical trial
Health-Related Quality Of Life
Patient reported outcomes
Remission
EMOTIONAL VITALITY
DISEASE
QUESTIONNAIRE
MORTALITY
REGISTER
BENEFITS
CRITERIA
THERAPY
FATIGUE
SCORES
3121 General medicine, internal medicine and other clinical medicine
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