Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Clinical Advantage of Attaining Index-Based Remission Criteria prior to Composite Remission in Treating Rheumatoid Arthritis

Version 1 : Received: 30 May 2021 / Approved: 31 May 2021 / Online: 31 May 2021 (09:50:34 CEST)

How to cite: Yoshii, I.; Chijiwa, T.; Sawada, N. Clinical Advantage of Attaining Index-Based Remission Criteria prior to Composite Remission in Treating Rheumatoid Arthritis. Preprints 2021, 2021050723 (doi: 10.20944/preprints202105.0723.v1). Yoshii, I.; Chijiwa, T.; Sawada, N. Clinical Advantage of Attaining Index-Based Remission Criteria prior to Composite Remission in Treating Rheumatoid Arthritis. Preprints 2021, 2021050723 (doi: 10.20944/preprints202105.0723.v1).

Abstract

Background and objectives: The clinical advantage of targeting index-based remission criteria (IR) prior to Boolean remission (BR) was evaluated retrospectively. Materials and Methods: A total of 578 patients with rheumatoid arthritis (RA), who were treated for more than three years, were recruited. Patients who were treated to targeted IR and composite measure remission criteria such as BR from the first consultation were divided according to the turn of attaining BR and IR: IB-R, a group that matched IR at the same time BR is attained or earlier; BI-F, a group that attained BR followed by IR or failed; IR-BF, a group that could not attain BR despite attaining IR; Both-F, a group that failed to attain either BR or IR. Background factors were statistically compared among groups. The BR rate in patients who attained IR (BRR) and the rate of failure to attain IR in patients who failed to attain BR (BFR) were statistically evaluated. Results: Groups made of 225, 231, and 482 in IB-R; 160, 154, and 8 in BI-F; 18, 18, and 75 in IR-BF; and 175, 175, and 13 in Both-F when indexing the clinical disease activity index (CDAI), simplified disease activity index (SDAI), and 28-joints disease activity score with C-reactive protein (DAS28-CRP), respectively. Disease activity indices’ scores after BR demonstrated significantly higher in the BI-F group than in the IB-R group. BRR was 92.6%, 92.8%, and 86.5%, while BFR was 71.3%, 71.3%, and 13.8% when indexing CDAI, SDAI, and DAS28-CRP, respectively. Conclusions: Targeting CDAI and SDAI remission prior to BR contributes to a stable clinical course.

Keywords

rheumatoid arthritis; remission; ADL; therapeutic index

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