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Remission in early rheumatoid arthritis treated with conventional DMARDs. Results of a two-year follow-up study of El Ayachi Moroccan cohort.
MedLine Citation:
PMID:  21497534     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: This study aimed to evaluate remission in patients with early RA treated by conventional DMARDs and to identify its possible predictor factors. METHODS: Patients with early RA (<12months) were enrolled in a 2-year follow-up study. Standard evaluation completed at baseline and at 24months included clinical, laboratory, functional and structural assessment. Clinical remission after 2years of follow-up was defined when DAS28 was less than 2.6. Possible predictor factors for remission were analyzed. RESULTS: Fifty-one patients (88.2% women, mean age of 46.9 [24-72] years, mean disease duration of 24 [6-48] weeks) were enrolled in this study. The delay in referral for specialist care was 140 [7-420] days. Rheumatoid factor, anti-CCP, HLA-DRB1*01 and DRB1*04 alleles were present respectively in 62.5, 56.6, 11.8, and 45.1% of patients. At 24months, 77.2% received a median dose of 5 (0-8) mg/day of prednisone and 65.2% was taking methotrexate (MTX). 13.6% of patients had stopped their DMARD because of socioeconomic difficulties. At 24months, we noted a significant improvement of morning stiffness, pain score, swollen joint count, ESR, CRP, DAS28 and HAQ scores. Remission at 2years was noted in 34.8% of patients and was significantly associated in univariate but not in multivariate analysis to male sex (P=0.02) and to short delay in referral for specialist (P=0.03). CONCLUSION: In this cohort of early RA patients treated with conventional DMARDs, especially with methotrexate in monotherapy, remission at 2-year of follow-up was obtained in one third of patients. No predictor factors of remission were found out. These results should be verified by further studies.
Authors:
Karima Benbouazza; Hanan Rkain; Bahia Benchekroun; Bouchra Amine; Fatiha Bzami; Leila Benbrahim; Ouafa Atouf; Malika Essakalli; Redouane Abouqal; Maxime Dougados; Najia Hajjaj-Hassouni
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-14
Journal Detail:
Title:  Joint, bone, spine : revue du rhumatisme     Volume:  -     ISSN:  1778-7254     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100938016     Medline TA:  Joint Bone Spine     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.
Affiliation:
Rheumatology Department, Mohamed Vth University Souissi, El Ayachi Hospital, Salé, Ibn Sina Universitary Hospital, Rabat, Morocco.
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