Longitudinal study of clinical prognostic factors in patients with early rheumatoid arthritis: the PREDICT study

Abstract

Aim: To assess the association between baseline clinical prognostic factors and subsequent Disease Activity Scoreof 28 joints (DAS28) remission in early rheumatoid arthritis (RA).Methods: Data were collected using point of care clinical software from participating rheumatology centres.Patients aged 18 years or over whose date of clinical onset of RA was within the previous 12–24 months, whohad at least 6 months of follow-up data and a DAS28-ESR (erythrocyte sedimentation rate) score recordedbetween 12 and 24 months from first being seen for RA were included. Data collected included baseline demo-graphics, mode of disease onset, pattern of joint involvement at onset, smoking status, DAS28, rheumatoid fac-tor (RF), anti-citrullinated peptide antibodies (ACPA), time from symptom onset to presentation and diseaseactivity at baseline. Univariate and multivariate logistic regression of DAS28-ESR remission between 12 and24 months after first assessment were performed.Results: Data from 1017 patients were analyzed: 70% female; mean age 60 years (SD: 14.7); 70% RF-positive,58% ACPA-positive. The strongest age and sex adjusted baseline predictors of DAS28-ESR remission at 12–24 months were remission at baseline (odds ratio [OR]: 4.49, 95% CI: 2.17 –9.29, P < 0.001), being male (OR:2.42, 95% CI: 1.46 –4.01, P < 0.001), abstaining from alcohol (P < 0.001) and being lower weight (OR: 0.98,95% CI: 0.97–1.00, P = 0.015). There was no statistically significant association between joint onset patterns,mode of onset, RF, ACPA or smoking status.Conclusion: In this observational study, patients with early RA at risk of not achieving remission include thosewith high disease activity at baseline, women, those who drink alcohol and those with higher body weight.