Early RA and the Chance of DMARD-Free Remission Save

Early and aggressive treatment of rheumatoid arthritis has become the mantra for most who manage the disease and hope to achieve optimal outcomes - including remission. But what is the chance of drug-free remission and how is it best achieved? This issue was studied by Ajeganova and coworkers as the look back at the outcomes of the Leiden Early Arthritis Clinic. (Citation source http://buff.ly/1EfQWOM)

The ability of early RA patients (n - 1003) to achieve DMARD-free sustained remission was analyzed between 1993 and 2011. Patients were treated differently in different eras. Those included in 1993–1995 were treated with non-steroidal anti-inflammatory drugs, in 1996–1998 mild DMARDs were started early, from 1999 onwards methotrexate was initiated promptly and from 2005 onward disease activity score (DAS) steered treatment.

Overall, 155 patients achieved DMARD-free sustained remission. The most aggressive treatment strategies were significantly associated with achieving remission (p0.001).  The odds of achieving DMARD-free sustained remission were significantly increased for those receiving early methotrexate and DAS-steered therapy.

Clearly, intensive treatment strategies increased the chance for DMARD-free sustained remission.  These data are similar to other studies suggesting the chance of DMARD-free remission in RA is between 10-15%.