Longitudinal study of clinical prognostic factors in patients with early rheumatoid arthritis: the PREDICT PREDICT study

摘要

Abstract Aim To assess the association between baseline clinical prognostic factors and subsequent Disease Activity Score of 28 joints ( DAS 28) remission in early rheumatoid arthritis ( RA ). Methods Data were collected using point of care clinical software from participating rheumatology centres. Patients aged 18 years or over whose date of clinical onset of RA was within the previous 12–24 months, who had at least 6 months of follow‐up data and a DAS 28‐ ESR (erythrocyte sedimentation rate) score recorded between 12 and 24 months from first being seen for RA were included. Data collected included baseline demographics, mode of disease onset, pattern of joint involvement at onset, smoking status, DAS 28, rheumatoid factor ( RF ), anti‐citrullinated peptide antibodies ( ACPA ), time from symptom onset to presentation and disease activity at baseline. Univariate and multivariate logistic regression of DAS 28‐ ESR remission between 12 and 24 months after first assessment were performed. Results Data from 1017 patients were analyzed: 70% female; mean age 60 years ( SD : 14.7); 70% RF ‐positive, 58% ACPA ‐positive. The strongest age and sex adjusted baseline predictors of DAS 28‐ ESR remission at 12–24 months were remission at baseline (odds ratio [ OR ]: 4.49, 95% CI : 2.17–9.29, P 0.001), being male ( OR : 2.42, 95% CI : 1.46–4.01, P 0.001), abstaining from alcohol ( P 0.001) and being lower weight ( OR : 0.98, 95% CI : 0.97–1.00, P = 0.015). There was no statistically significant association between joint onset patterns, mode of onset, RF , ACPA or smoking status. Conclusion In this observational study, patients with early RA at risk of not achieving remission include those with high disease activity at baseline, women, those who drink alcohol and those with higher body weight.