Prevalence and predictors for sustained remission in rheumatoid arthritis

Yoon-Kyoung Sung, Kazuki Yoshida, Femke H.M. Prince, Michelle L. Frits, Soo-Kyung Cho, Jung Yoon Choe, Hye-Soon Lee, Jisoo Lee, Shin Seok Lee, Dae-Hyun Yoo, Simon M. Helfgott, Nancy A. Shadick, Michael E. Weinblatt, Daniel H. Solomon, Sang Cheol Bae

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Abstract

Objective Remission is a key goal in managing rheumatoid arthritis (RA), with sustained remission as the preferred sequelae of short-term remission. However little is known about the predictors of sustained remission for patients reaching remission. Using two independent cohorts, we aimed to evaluate the prevalence and predictors for sustained remission. Methods The study cohort consisted of subjects with RA from the Brigham and Women's Hospital Rheumatoid Arthritis Sequential Study (BRASS) and the Korean Observational Study Network for Arthritis (KORONA). We analyzed subjects who reached remission in 2009 with follow up data for two consecutive years. Remission was defined by the Disease Activity Score 28- (DAS28-CRP) of less than 2.6. Sustained remission was defined as three consecutive annual visits in remission. Predictors for sustained remission were identified by multivariate logistic regression analysis. Results A total of 465 subjects were in remission in 2009. Sustained remission was achieved by 53 of 92 (57.5%) in BRASS and by 198 of 373 (53.1%) in KORONA. In multivariate analyses, baseline predictors of sustained remission were: Disease duration less than 5 years [odds ratio (OR) 1.96, 95% confidence interval (95% CI) 1.08-3.58], Modified Health Assessment Questionnaire (MHAQ) score of 0 (OR 1.80, 95% CI 1.18-2.74), and non-use of oral glucocorticoid (OR 1.58, 95% CI 1.01-2.47). Conclusion More than half of RA subjects in remission in 2009 remained in remission through 2011. Short disease duration, no disability, and non-use of oral glucocorticoid at baseline were associated with sustained remission.

Original languageEnglish
Article numbere0214981
JournalPLoS ONE
Volume14
Issue number4
DOIs
StatePublished - 2019 Apr 1

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rheumatoid arthritis
remission
Rheumatoid Arthritis
Glucocorticoids
Odds Ratio
Confidence Intervals
Arthritis
Observational Studies
Regression analysis
Logistics
Health
odds ratio
Cohort Studies
Multivariate Analysis
Logistic Models
confidence interval
Regression Analysis
arthritis
observational studies
glucocorticoids

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Sung, Yoon-Kyoung ; Yoshida, Kazuki ; Prince, Femke H.M. ; Frits, Michelle L. ; Cho, Soo-Kyung ; Choe, Jung Yoon ; Lee, Hye-Soon ; Lee, Jisoo ; Lee, Shin Seok ; Yoo, Dae-Hyun ; Helfgott, Simon M. ; Shadick, Nancy A. ; Weinblatt, Michael E. ; Solomon, Daniel H. ; Bae, Sang Cheol. / Prevalence and predictors for sustained remission in rheumatoid arthritis. In: PLoS ONE. 2019 ; Vol. 14, No. 4.
@article{b3ec49a916f4434ca4451abf615a9398,
title = "Prevalence and predictors for sustained remission in rheumatoid arthritis",
abstract = "Objective Remission is a key goal in managing rheumatoid arthritis (RA), with sustained remission as the preferred sequelae of short-term remission. However little is known about the predictors of sustained remission for patients reaching remission. Using two independent cohorts, we aimed to evaluate the prevalence and predictors for sustained remission. Methods The study cohort consisted of subjects with RA from the Brigham and Women's Hospital Rheumatoid Arthritis Sequential Study (BRASS) and the Korean Observational Study Network for Arthritis (KORONA). We analyzed subjects who reached remission in 2009 with follow up data for two consecutive years. Remission was defined by the Disease Activity Score 28- (DAS28-CRP) of less than 2.6. Sustained remission was defined as three consecutive annual visits in remission. Predictors for sustained remission were identified by multivariate logistic regression analysis. Results A total of 465 subjects were in remission in 2009. Sustained remission was achieved by 53 of 92 (57.5{\%}) in BRASS and by 198 of 373 (53.1{\%}) in KORONA. In multivariate analyses, baseline predictors of sustained remission were: Disease duration less than 5 years [odds ratio (OR) 1.96, 95{\%} confidence interval (95{\%} CI) 1.08-3.58], Modified Health Assessment Questionnaire (MHAQ) score of 0 (OR 1.80, 95{\%} CI 1.18-2.74), and non-use of oral glucocorticoid (OR 1.58, 95{\%} CI 1.01-2.47). Conclusion More than half of RA subjects in remission in 2009 remained in remission through 2011. Short disease duration, no disability, and non-use of oral glucocorticoid at baseline were associated with sustained remission.",
author = "Yoon-Kyoung Sung and Kazuki Yoshida and Prince, {Femke H.M.} and Frits, {Michelle L.} and Soo-Kyung Cho and Choe, {Jung Yoon} and Hye-Soon Lee and Jisoo Lee and Lee, {Shin Seok} and Dae-Hyun Yoo and Helfgott, {Simon M.} and Shadick, {Nancy A.} and Weinblatt, {Michael E.} and Solomon, {Daniel H.} and Bae, {Sang Cheol}",
year = "2019",
month = "4",
day = "1",
doi = "10.1371/journal.pone.0214981",
language = "English",
volume = "14",
journal = "PloS one",
issn = "1932-6203",
number = "4",

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Sung, Y-K, Yoshida, K, Prince, FHM, Frits, ML, Cho, S-K, Choe, JY, Lee, H-S, Lee, J, Lee, SS, Yoo, D-H, Helfgott, SM, Shadick, NA, Weinblatt, ME, Solomon, DH & Bae, SC 2019, 'Prevalence and predictors for sustained remission in rheumatoid arthritis', PLoS ONE, vol. 14, no. 4, e0214981. https://doi.org/10.1371/journal.pone.0214981

Prevalence and predictors for sustained remission in rheumatoid arthritis. / Sung, Yoon-Kyoung; Yoshida, Kazuki; Prince, Femke H.M.; Frits, Michelle L.; Cho, Soo-Kyung; Choe, Jung Yoon; Lee, Hye-Soon; Lee, Jisoo; Lee, Shin Seok; Yoo, Dae-Hyun; Helfgott, Simon M.; Shadick, Nancy A.; Weinblatt, Michael E.; Solomon, Daniel H.; Bae, Sang Cheol.

In: PLoS ONE, Vol. 14, No. 4, e0214981, 01.04.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Prevalence and predictors for sustained remission in rheumatoid arthritis

AU - Sung, Yoon-Kyoung

AU - Yoshida, Kazuki

AU - Prince, Femke H.M.

AU - Frits, Michelle L.

AU - Cho, Soo-Kyung

AU - Choe, Jung Yoon

AU - Lee, Hye-Soon

AU - Lee, Jisoo

AU - Lee, Shin Seok

AU - Yoo, Dae-Hyun

AU - Helfgott, Simon M.

AU - Shadick, Nancy A.

AU - Weinblatt, Michael E.

AU - Solomon, Daniel H.

AU - Bae, Sang Cheol

PY - 2019/4/1

Y1 - 2019/4/1

N2 - Objective Remission is a key goal in managing rheumatoid arthritis (RA), with sustained remission as the preferred sequelae of short-term remission. However little is known about the predictors of sustained remission for patients reaching remission. Using two independent cohorts, we aimed to evaluate the prevalence and predictors for sustained remission. Methods The study cohort consisted of subjects with RA from the Brigham and Women's Hospital Rheumatoid Arthritis Sequential Study (BRASS) and the Korean Observational Study Network for Arthritis (KORONA). We analyzed subjects who reached remission in 2009 with follow up data for two consecutive years. Remission was defined by the Disease Activity Score 28- (DAS28-CRP) of less than 2.6. Sustained remission was defined as three consecutive annual visits in remission. Predictors for sustained remission were identified by multivariate logistic regression analysis. Results A total of 465 subjects were in remission in 2009. Sustained remission was achieved by 53 of 92 (57.5%) in BRASS and by 198 of 373 (53.1%) in KORONA. In multivariate analyses, baseline predictors of sustained remission were: Disease duration less than 5 years [odds ratio (OR) 1.96, 95% confidence interval (95% CI) 1.08-3.58], Modified Health Assessment Questionnaire (MHAQ) score of 0 (OR 1.80, 95% CI 1.18-2.74), and non-use of oral glucocorticoid (OR 1.58, 95% CI 1.01-2.47). Conclusion More than half of RA subjects in remission in 2009 remained in remission through 2011. Short disease duration, no disability, and non-use of oral glucocorticoid at baseline were associated with sustained remission.

AB - Objective Remission is a key goal in managing rheumatoid arthritis (RA), with sustained remission as the preferred sequelae of short-term remission. However little is known about the predictors of sustained remission for patients reaching remission. Using two independent cohorts, we aimed to evaluate the prevalence and predictors for sustained remission. Methods The study cohort consisted of subjects with RA from the Brigham and Women's Hospital Rheumatoid Arthritis Sequential Study (BRASS) and the Korean Observational Study Network for Arthritis (KORONA). We analyzed subjects who reached remission in 2009 with follow up data for two consecutive years. Remission was defined by the Disease Activity Score 28- (DAS28-CRP) of less than 2.6. Sustained remission was defined as three consecutive annual visits in remission. Predictors for sustained remission were identified by multivariate logistic regression analysis. Results A total of 465 subjects were in remission in 2009. Sustained remission was achieved by 53 of 92 (57.5%) in BRASS and by 198 of 373 (53.1%) in KORONA. In multivariate analyses, baseline predictors of sustained remission were: Disease duration less than 5 years [odds ratio (OR) 1.96, 95% confidence interval (95% CI) 1.08-3.58], Modified Health Assessment Questionnaire (MHAQ) score of 0 (OR 1.80, 95% CI 1.18-2.74), and non-use of oral glucocorticoid (OR 1.58, 95% CI 1.01-2.47). Conclusion More than half of RA subjects in remission in 2009 remained in remission through 2011. Short disease duration, no disability, and non-use of oral glucocorticoid at baseline were associated with sustained remission.

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U2 - 10.1371/journal.pone.0214981

DO - 10.1371/journal.pone.0214981

M3 - Article

VL - 14

JO - PloS one

JF - PloS one

SN - 1932-6203

IS - 4

M1 - e0214981

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