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Remission Tied to Earlier Rheumatoid Arthritis Treatment

Increased likelihood of clinical and sustained remission for patients who get earlier treatment

MONDAY, March 7 (HealthDay News) -- For patients with rheumatoid arthritis (RA), earlier treatment is associated with an increased likelihood of achieving remission, according to a study published online Feb. 18 in Arthritis Care & Research.

Daniel E. Furst, M.D., from the University of California in Los Angeles, and colleagues assessed the association between disease duration and remission in RA patients. Patients from the Consortium of Rheumatology Researchers of North America (CORRONA) registry who were recently prescribed a nonbiologic disease-modifying antirheumatic drug (nbDMARD) (1,646 patients) or anti-tumor necrosis factor (TNF) (3,179 patients) and had at least one follow-up visit were included. Remission was defined using the Clinical Disease Activity Index (CDAI) and the 28-joint Disease Activity Score (DAS28) at a follow-up visit within a year, and sustained remission lasted for two successive visits.

The researchers found that for patients treated with both nbDMARD and anti-TNF initiators, there was a significant association between CDAI remission and time of treatment initiation (starting at or before five years, compared to at or after 11 years). Sustained remission was also associated with earlier treatment initiation. DAS28 results were similar. In adjusted analyses, a five-year increase in disease duration was associated with reduced likelihood of CDAI remission in nbDMARD (odds ratio [OR], 0.91), or anti-TNF (OR, 0.88). The likelihood of sustained remission was also reduced according to CDAI in nbDMARD (OR, 0.61) and anti-TNF (OR, 0.85).

"Early and aggressive treatment of RA is an appropriate strategy in order to achieve remission as soon as possible after the onset of the disease," the authors write.

Several of the study authors disclosed financial relationships with a number of pharmaceutical companies, including Abbott, Amgen, BMS, Centocor, Genentech, Lilly, and Roche, which supported the CORRONA database.

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