Clinical predictors of remission and low disease activity in Latin American early rheumatoid arthritis: data from the GLADAR cohort (vol 38, pg 2737, 2019)

被引：0

作者：

Gamboa-Cardenas, Rocio V. ^{[1
]}

Ugarte-Gil, Manuel F. ^{[1
,2
]}

Massardo, Loreto ^{[3
]}

Sacnun, Monica P. ^{[4
]}

Saurit, Veronica ^{[5
]}

Cardiel, Mario H. ^{[6
]}

Soriano, Enrique R. ^{[7
]}

Pisoni, Cecilia ^{[8
]}

Galarza-Maldonado, Claudio M. ^{[9
]}

Rios, Carlos ^{[10
]}

Radominski, Sebastiao C. ^{[11
]}

Castelar-Pinheiro, Geraldo da R. ^{[12
]}

Bianchi, Washington Alves ^{[13
]}

Appenzeller, Simone ^{[14
]}

da Silveira, Ines Guimaraes ^{[15
]}

de Freitas Zerbini, Cristiano A. ^{[16
]}

Caballero-Uribe, Carlo V. ^{[17
]}

Rojas-Villarraga, Adriana ^{[18
]}

Guibert-Toledano, Marlene ^{[19
]}

Ballesteros, Francisco ^{[20
]}

Montufar, Ruben ^{[21
]}

Vazquez-Mellado, Janitzia ^{[22
]}

Esquivel-Valerio, Jorge ^{[23
]}

De La Torre, Ignacio Garcia ^{[24
]}

Barile-Fabris, Leonor A. ^{[25
]}

Palezuelos, Fedra Irazoque ^{[26
]}

Andrade-Ortega, Lilia ^{[26
]}

Monge, Pablo ^{[27
]}

Teijeiro, Raquel ^{[28
]}

Achurra-Castillo, Angel F. ^{[29
]}

Esteva Spinetti, Maria H. ^{[30
]}

Alarcon, Graciela S. ^{[31
]}

Pons-Estel, Bernardo A. ^{[4
,32
]}

机构：

[1] Hosp Nacl Guillermo Almenara Irigoyen, EsSalud, Serv Reumatol, Ave Miguel Grau 800, Lima 15033, Peru

[2] Univ Cient Sur, Lima, Peru

[3] Univ San Sebastian, Fac Med & Ciencia, Ctr Biol Celular & Biomed CEBICEM, Santiago, Chile

[4] Hosp Prov Rosario, Serv Reumatol, Rosario, Santa Fe, Argentina

[5] Hosp Privado Univ Cordoba, Serv Reumatol, Cordoba, Argentina

[6] Ctr Invest Clin Morelia, Morelia, Michoacan, Mexico

[7] Hosp Italiano Buenos Aires, Serv Clin Med, Secc Reumatol, Buenos Aires, DF, Argentina

[8] Ctr Educ Med Invest Clin Norberto Quirno CEMIC, Secc Inmunol & Reumatol, Buenos Aires, DF, Argentina

[9] Corp Med Monte Sinai, Unidad Enfermedades Reumat & Autoinmunes UNERA, Cuenca, Ecuador

[10] Univ Espiritu Santo, Ctr Reumatol & Rehabil, Guayaquil, Ecuador

[11] Univ Fed Parana, Hosp Clin, Serv Reumatol, Curitiba, Parana, Brazil

[12] Univ Estado Rio de Janeiro, Dept Med Interna, Disciplina Reumatol, Rio De Janeiro, Brazil

[13] Univ Estado Rio de Janeiro, Fac Ciencias Med, Dept Med Interna,Fac Med,Univ Estacio Sa, Serv Reumatol,Hosp Gen Santa Casa Misericordia Ri, Rio De Janeiro, Brazil

[14] Univ Estadual Campinas, Rheumatol Unit, Sch Med Sci, Campinas, SP, Brazil

[15] Pontificia Univ Catolica Rio Grande do Sul, Porto Alegre, RS, Brazil

[16] Ctr Paulista Invest Clin, Sao Paulo, Brazil

[17] Hosp Univ Norte, Serv Reumatol, Barranquilla, Colombia

[18] Fdn Univ Ciencias Salud FUCS, Bogota, Colombia

[19] Hosp Clin Quirurg Diez de Octubre, Serv Reumatol, Havana, Cuba

[20] Hosp Clin San Borja Arriaran, Serv Reumatol, Santiago, Chile

[21] Consultorio Especialidades Inst Salvadoreno Segur, Dept Reumatol, San Salvador, El Salvador

[22] Hosp Gen Mexico City, Serv Reumatol, Mexico City, DF, Mexico

[23] Hosp Univ Dr Jose Eleuterio Gonzalez, Serv Reumatol, Monterrey, Mexico

[24] Univ Guadalajara, Hosp Gen Occidente, Dept Inmunol & Reumatol, Guadalajara, Jalisco, Mexico

[25] Hosp Angeles Pedregal, Serv Reumatol, Mexico City, DF, Mexico

[26] Cto Med Nacl 20 Noviembre, Serv Reumatol, Mexico City, DF, Mexico

[27] Univ Costa Rica, HospitalMexico, Caja Costarricense Seguro Social, San Jose, Costa Rica

[28] MUCAM, Montevideo, Uruguay

[29] Complejo Hosp Metropolitano Dr Arnulfo Arias Madr, Caja Seguro Social Panama, Panama City, Panama

[30] Hosp Cent San Cristobal, Dept Med, Serv Reumatol, San Cristobal, Venezuela

[31] Univ Alabama Birmingham, Sch Med, Dept Med, Div Clin Immunol & Rheumatol, Birmingham, AL USA

[32] Ctr Reg Enfermedades Autoinmunes & Reumat CREAR, Dept Med Interna, Grp Orono, Rosario, Santa Fe, Argentina

来源：

CLINICAL RHEUMATOLOGY | 2019年 / 38卷 / 10期

关键词：

Early RA outcomes; Early RA remission; Early RA response predictors; Latin America early RA;

D O I：

10.1007/s10067-019-04742-8

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives: To identify baseline predictors of remission and low disease activity (LDA) in early rheumatoid arthritis (RA) from the GLADAR (Grupo Latino Americano De estudio de la Artritis Reumatoide) cohort. Methods: Patients with 1- and 2-year follow-up visits were included. Remission and LDA were defined by DAS28-ESR (< 2.6 and ≤ 3.2, respectively). Baseline predictors examined were gender, ethnicity, age at diagnosis, socioeconomic status, symptoms’ duration, DMARDs, RF, thrombocytosis, anemia, morning stiffness, DAS28-ESR (and its components), HAQ-DI, DMARDs and corticosteroid use, and Sharp-VDH score. Multivariable binary logistic regression models (excluding DAS28-ESR components to avoid over adjustment) were derived using a backward selection method (α-level set at 0.05). Results: Four hundred ninety-eight patients were included. Remission and LDA/remission were met by 19.3% and 32.5% at the 1-year visit, respectively. For the 280 patients followed for 2 years, these outcomes were met by 24.3% and 38.9%, respectively. Predictors of remission at 1 year were a lower DAS28-ESR (OR 1.17; CI 1.07–1.27; p = 0.001) and HAQ-DI (OR 1.48; CI 1.04–2.10; p = 0.028). At 2 years, only DAS28-ESR (OR 1.40; CI 1.17–1.6; p < 0.001) was a predictor. Predictors of LDA/remission at 1 year were DAS28-ESR (OR 1.42; CI 1.26–1.61; p < 0.001), non-use of corticosteroid (OR 1.74; CI 1.11–2.44; p = 0.008), and male gender (OR 1.77; CI 1.2–2.63; p = 0.036). A lower baseline DAS28-ESR (OR 1.45; CI 1.23–1.70; p < 0.001) was the only predictor of LDA/remission at 2 years. Conclusions: A lower disease activity consistently predicted remission and LDA/remission at 1 and 2 years of follow-up in early RA patients from the GLADAR cohort.Key Points• In patients with early RA, a lower disease activity at first visit is a strong clinical predictor of achieving remission and LDA subsequently.• Other clinical predictors of remission and LDA to keep in mind in these patients are male gender, non-use of corticosteroids and low disability at baseline.• Not using corticosteroids at first visit is associated with a lower disease activity and predicts LDA/remission at 1 year in these patients. © 2019, International League of Associations for Rheumatology (ILAR).

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页码：2963 / 2964

页数：2

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