A comparison of long-term outcomes in rheumatoid arthritis patients

This study examined whether rheumatoid arthritis patients with persistent moderate disease activity have a worse outcome than patients that achieve remission.

The severity of rheumatoid arthritis (RA) varies between patients. Treatments are given early after diagnosis in order to stop or reduce joint damage. Some RA patients may achieve remission (no signs and symptoms of disease) after treatment. Other patients may have a persistent mild, moderate or severe form of the disease even with treatment. The majority of patients have persistent moderate disease activity. It is believed that patients with persistent moderate RA have a worse outcome in comparison to patients that achieve remission in the first year after diagnosis.

This study compared the 3-5 year outcome for RA patients with moderate disease activity to patients that achieved remission. This study involved 262 recently diagnosed RA patients. 107 patients had persistent moderate disease activity. 155 achieved remission in the first year after diagnosis. Patients were followed up every 6 months for the first 2 years and every year thereafter. X-rays of the joints were taken 3 years after the beginning of the study in order to assess joint damage. Clinical remission and the number of missed workdays were assessed 5 years after the beginning of the study. 

Patients with persistent moderate RA had a greater progression of joint damage in comparison to those that achieved remission within a year of diagnosis. Patients with persistent moderate RA were also 7-11 times less likely to achieve remission. Patients with persistent moderate RA missed more workdays (272 days) over 5 years than patients that achieved remission (42 days). 

This study concluded that patients with persistent moderate RA have a worse outcome than patients that achieve remission within a year of diagnosis.

Only 2 measurements of disease activity were taken during the first year of follow-up. This makes it difficult to determine whether those in remission remained in remission throughout the study. 

Consult your physician regarding the various treatments available if you have persistent moderate rheumatoid arthritis.