Rapid remission achieved in real world setting | Arthritis Information

As many as half of all early rheumatoid arthritis patients may achieve remission within 36 weeks following step-up treatment coupled with tight control, according to new research presented at the annual European League Against Rheumatism meeting in Paris, France.

"Our data show that also in daily clinical practice it is possible to achieve low disease activity state as well as remission in RA," conclude the researchers led by H. H. (Ina) Kuper, MD, of Medisch Spectrum Twente and University Twente, Almelo, The Netherlands. Moreover, "remission is achieved rapidly in a considerable percentage of patients with recently onset RA using a tight step-up DMARD treatment scheme aiming at remission."

Rapid remission achieved in real world setting

The new prospective study comprised 169 DMARD-naïve, early RA patients from the Dutch Rheumatoid Arthritis Monitoring Registry. Remission was defined as a Disease Activity Score 28 (DAS28) of <2.6, for which 15.5% of patients achieved this score by week 8, 22.2% achieved this score by week 12, and 30.7% by week 20. Furthermore, the study showed that 38.8% achieved remission by week 24, 52.1% by week 36, and 51% by weeks 48 to 52.

Baseline patient characteristics were comparable: 57.3 years was average patient age, 63.9% were female, and 52.7% were rheumatoid factor positive. Patients’ average disease duration was 16 weeks.

Step-up, tight control regimen defined

Patients received 15 mg/week of methotrexate (MTX) following diagnosis. If remission was not achieved at week 8, MTX dose was increased to 25 mg/week. If remission was not achieved at week 12, sulfasalazine (SSZ) 2 g/day was added. If by week 20 remission was not achieved, SSZ was increased to 3 g/day. If at week 24 remission still remained elusive, adalimumab was added to MTX. Therapy could be adjusted every 3 months based on DAS28. Thereafter, other TNF-blockers may be tried. Patients were allowed to take nonsteroidal anti-inflammatory drugs, prednisolone ≤10 mg/day, and intra-articular corticosteroid injections could be administered.

Reference
1. Kuper HH, Hoekstra M, ten Klooster P, et al. Remission can be achieved in 50% of early rheumatoid arthritis patients after 25 weeks in daily clinical practice. Presented at: EULAR 2008; June 11-14, 2008; Paris, France. Abstract OP-0003.

Lynn492008-06-13 08:19:53TTTWhat does TTT mean?

ttt=to the top

its a way of bumping a message up without typing a message

l thought it was uncommon to get the first signs of RA over 50?

Also, if you're allergic to sulpher & get ill from mx do they start you on "other TNF blockers" straight away? Admirable that it is put under control early on, but I do feel for patients who get bad side-effects, it would make them feel so sick. I'd want my general practitioner to be talking with my rheumatologist if I had to go through this.

Last year I went through a botched attempt at chemo for breast cancer and ended up unable to finish the chemo. That was >1 year ago and am only now easing back onto Arava, hence my current flare. My oncologist and rheumatologist had no communication with each other at any time. I had to try to play message-girl and decision-maker about whether to continue the Arava or not. 6 months after the chemo I ended up unable to take so much as a painkiller because my body had been overloaded with chemicals (I would get the same side effects as the chemo, only much milder).

I'm sure this could have been an easier ride for me if they'd just picked up the phone.

l thought it was uncommon to get the first signs of RA over 50?

Not for me, age 56 when my ship struck the rocks.
The hull was breached in many places but the ship has stayed afloat.
The gaping holes have now been patched with only a few minor leaks.

The bilge pumps should now be able to handle what remains.

It has taken near 20 months to make good the repairs.
Bodak2008-06-13 16:45:07Hi Stephen,

Must have been the word 'admirable' that set you off on that little sea jaunt. I'll be more careful in future My sister was 61 when it hit her and my "RA wannabe" symptoms started at around 50 but it was such a gradual progression that it's hard for me to say for sure. uggh
that medicine dose would not be a good thing...for me anyway.

I am trying AP
I really get destroyed by these medicines...
I get mouth sores, loose my hair and look like a ghost

I am hoping that the treatment is effective to put me into remission without so much medicine.

I am 39 and have young kids
I went into remission last year....
now it is back:(

It is such a personal decision I know...
whatever works;)

I was 41 when I was diagnosed with RA. I have friends who were in their 50's when they were diagnosed, seems that it varies quite a bit.

Different people react differently to the various meds. I've never had any significant side effects from MTX and I used it for 8 years.

I believe and my test results verify, that I am heading toward remission because of Rituxan. It has worked wonderfully for me and I haven't had side effects from it either.

Lynn492008-06-14 08:15:38Because I'm in clinical remission doesn't mean that there aren't any mild side effects from the drugs. I feel that mouth sores and hair loss are less of a problem than not being able to walk. To date I haven't had any side effects that I couldn't resolve. Like any other person on medication and treatment, that could change, and when it and if it does then I'll have to deal with the side effects. LindyLin, are you saying that you can go along with no side effects and then start having them even though you're meds haven't changed?There is late onset RA. I was diagnosed at 65 although I think I had had it for a year or more. I saw a post by a woman diagnosed at 75!!

Take care at any age.

Jan