Outcome in rheumatoid arthritis patients with continued conventional therapy for moderate disease activity--the early RA network (ERAN).

Kiely P, Walsh D, Williams R, Young A; for the Early Rheumatoid Arthritis Network (ERAN).

Abstract

Objective. To report from early RA network (ERAN) on Years 2 and 3 28-joint DAS (DAS-28) and HAQ outcomes in newly diagnosed RA patients treated with DMARD therapies stratified to DAS-28 status after 1 year.

Methods. ERAN is a prospective observational cohort of newly diagnosed RA patients, monitored and treated according to local practice. Standardized case report forms are completed at first presentation, 3-6 months, 1 year and annually thereafter.

Results. A total of 418 newly diagnosed RA patients with 2 years and 302 with 3 years follow-up were identified in 22 ERAN centres from 2002 to 2008. Within their first year from registration, 67% of patients received monotherapy DMARDs, and 26% combination DMARDs including 2% were on anti-TNF therapies. Between Years 1 and 3, 60% received DMARD monotherapy, 34% combination DMARD therapy including 8% on anti-TNF therapies. Seventy-four per cent of patients with Year 1 DAS-28 <3.2 and 27% with DAS-28 3.2-5.1 achieved a DAS-28 <3.2 outcome at Year 2 [odds ratio (OR) 7.64; 95% CI 4.6, 12.6], and 71 and 35%, respectively, at Year 3 (OR 4.49; 95% CI 2.5, 7.9). Seventy-nine per cent of patients with a Year 1 DAS-28 <3.2 and 52% with DAS-28 3.2-5.1 achieved an HAQ <1.25 at Year 2 (OR 3.47; 95% CI 2.1, 5.6), and 81 and 47%, respectively, at Year 3 (OR 4.92; 95% CI 2.6, 9.0).

Conclusions. In RA patients with a DAS-28 3.2-5.1 at 1 year, the likelihood of achieving a target low DAS-28 <3.2, or a low HAQ, at Years 2 or 3 is poor in a routine care setting using conventional DMARDs according to current practice.

中等疾病活动度的RA患者持续传统治疗的结果：来自ERAN的数据

Kiely P,et al.Rheumatology (Oxford). 2010 Dec 17.

目的：报道早期RA网络（ERAN）中新近诊断的RA患者使用DMARD治疗，并根据第1年DAS28分层，报告其第2年和第3年DAS28、HAQ结果。

方法：ERAN是一个新近诊断RA患者的前瞻性观察性队列，由当地临床中心进行监测和治疗，在初次就诊、3-6个月、第1年填写标准化病例报告表，之后每年一次。

结果：2002-2008年，在22个ERAN中心共有418例新近诊断的RA患者完成2年随访，302例患者完成3年随访。第1年内，67%接受DMARDs单药治疗，26%联合DMARDs治疗，其中2%使用TNF抑制剂。在第1年至第3年，60%接受DMARDs单药治疗，34%联合DMARDs治疗，其中8%使用TNF抑制剂。74%第1年DAS28 <3.2的患者和27% DAS28 3.2-5.1的患者在第2年DAS28 <3.2（OR 7.64; 95% CI 4.6, 12.6），71%和35%分别在第3年DAS28 <3.2。79%第1年DAS28 <3.2的患者和52% DAS28 3.2-5.1的患者在第2年HAQ <1.25（OR 3.47; 95% CI 2.1, 5.6），81%和47%分别在第3年HAQ <1.25（OR 4.92; 95% CI 2.6, 9.0）。

结论：在目前的临床工作中、使用传统DMARDs情况下，第1年DAS28 3.2-5.1的RA患者在第2年或第3年达到DAS28 <3.2或HAQ积分低的可能性较小。