Factors influencing remission in rheumatoid arthritis patients: results from Karnataka rheumatoid arthritis comorbidity (KRAC) study.

Autor: Chandrashekara S; ChanRe Rheumatology and Immunology Center, Bangalore, India., Shobha V; St. John's Medical College Hospital, Bangalore, India., Dharmanand BG; Sakra Hospital, Bangalore, India., Jois R; Kanva Diagnostics Center, Bangalore, India., Kumar S; Columbia Asia Hospital, Bangalore, India., Mahendranath KM; Samarpan Health Centre, Bangalore, India., Haridas V; Arthritis Superspeciality Center, Hubli, India., Prasad S; Vikram Hospital Pvt. Ltd, Mysore, India., Singh Y; Manipal Hospital, Mysore, Karnataka, India., Daware MA; Narayana Health City, Mysore, Karnataka, India., Swamy A; Anurag Clinic, Mysore, Karnataka, India., Subramanian R; JSS Medical College, Mysore, Karnataka, India., Somashekar SA; Bangalore Rheumatology Center, Bangalore, India., Shanthappa AM; Arushi Rheumatology Center, Tumkur, India., Anupama KR; ChanRe Rheumatology and Immunology Center, Basaweswaranagar, Bangalore, India.
Jazyk: angličtina
Zdroj: International journal of rheumatic diseases [Int J Rheum Dis] 2018 Nov; Vol. 21 (11), pp. 1977-1985. Date of Electronic Publication: 2016 Jul 25.
DOI: 10.1111/1756-185X.12908
Abstrakt: Aim: To study the prevalence of remission in rheumatoid arthritis (RA) patients and the influence of different factors like literacy, socioeconomic status, presence of comorbidity and treatment strategy in achieving remission.
Methods: The study involved 1990 RA patients who were recruited for the Karnataka Rheumatoid arthritis comorbidity (KRAC) study. Based on the factors evaluated, the study participants were classified as follows: age, < 30 years, 30-39 years, 40-49 years, 50-59 years and ≥ 60 years; educational status, illiterate/no formal education, high school or less, graduate, post-graduate and doctorate; family income (₹ per annum), < 50 000, 50-100 000, 100-500 000, and > 500 000; duration of illness prior (DOIP): ≤ 6 months, 6-24 months, 24-120 months and > 120 months. Joint counts were performed by a rheumatologist or trained joint assessor. To assess the treatment outcome, the disease activity score was calculated using the Disease activity Score of 28 joints - erythrocyte sedimentation rate (DAS 28-3 ESR).
Results: As per the DAS 28-3 ESR score, around 20% (n = 397) of the study subjects achieved remission. The corresponding mean ± SD of DAS 28-3 ESR noted for remission and non-remission groups were 2.13 ± 0.42 and 4.32 ± 1.28. The majority of the patients were treated with double disease-modifying anti-rheumatic drugs (DMARDs) (60.7%). The likelihood of remission was found to be more in patients who reported DOIP ≤ 6 months. Furthermore, the chances of remission reduced with increase in patient's age and the highest remission rate was noted for 30-39 years age group (59%), followed by 40-49 years (35.4%) and 50-59 years (19.7%).
Conclusion: The prevalence of remission noted was around 20%. Early treatment, escalating dose of DMARDs, and patient counseling are important contributing factors for attaining remission.
(© 2016 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje