Further support for 3-month assessment to guide DMARD adjustment in RA patients
medwireNews: Measuring disease activity at 3 months can help predict DMARD response at 6 months in patients with rheumatoid arthritis (RA), researchers report.
The study included 1610 RA patients treated with conventional or biologic DMARDs and included in the NOR-DMARD registry between 2000 and 2012, 10.8% of whom achieved remission (SDAI score ≤3.3) and 36.0% of whom met the criteria for low disease activity (LDA; SDAI ≤11) at 6 months.
As reported in RMD Open, achieving a 50% improvement in SDAI criteria at 3 months was significantly associated with the likelihood of reaching remission at 6 months. When the analysis was restricted to patients with high disease activity (SDAI >26 points) at baseline, achieving a 70% improvement in SDAI at 3 months significantly predicted remission at 6 months.
A 51.2% improvement in SDAI at 3 months was significantly associated with LDA at 6 months among patients with high disease activity at baseline, while a 24.2% improvement at 3 months significantly predicted 6-month LDA in patients with moderate disease activity (SDAI >11 and ≤26 points).
Overall, these findings support current EULAR recommendations that suggest “considering treatment adjustments in case of less than 50% improvement in disease activity by 3 months,” say Vibeke Norvang (Diakonhjemmet Hospital, Oslo, Norway) and colleagues.
They point out, however, that the 3-month SDAI cutoffs for predicting outcomes varied depending on treatment target and baseline disease activity, “indicating that more specific recommendations might be needed for clinical decision-making at the 3-month time point.”
medwireNews is an independent medical news service provided by Springer Healthcare. © 2018 Springer Healthcare part of the Springer Nature group