Các yếu tố lâm sàng dự đoán sự thuyên giảm và hoạt động bệnh thấp trong viêm khớp dạng thấp sớm ở Mỹ Latinh: dữ liệu từ nhóm GLADAR

Clinical Rheumatology - Tập 38 - Trang 2737-2746 - 2019
Rocio V Gamboa-Cárdenas1, Manuel F. Ugarte-Gil1,2, Massardo Loreto3, Mónica P. Sacnun4, Verónica Saurit5, Mario H. Cardiel6, Enrique R. Soriano7, Cecilia Pisoni8, Claudio M. Galarza-Maldonado9, Carlos Rios10, Sebastião C. Radominski11, Geraldo da R. Castelar-Pinheiro12, Washington Alves Bianchi13, Simone Appenzeller14, Inés Guimarães da Silveira15, Cristiano A. de Freitas Zerbini16, Carlo V. Caballero-Uribe17, Adriana Rojas-Villarraga18, Marlene Guibert-Toledano19, Francisco Ballesteros20, Rubén Montufar21, Janitzia Vázquez-Mellado22, Jorge Esquivel-Valerio23, Ignacio García De La Torre24, Leonor A. Barile-Fabris25, Fedra Irazoque Palezuelos26, Lilia Andrade-Ortega26, Pablo Monge27, Raquel Teijeiro28, Ángel F. Achurra-Castillo29, María H. Esteva Spinetti30, Graciela S. Alarcón31, Bernardo A. Pons-Estel4,32
1Servicio de Reumatología, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
2Universidad Científica del Sur, Lima, Peru
3Centro de Biología Celular y Biomedicina (CEBICEM), Facultad de Medicina y Ciencia, Universidad San Sebastián, Santiago, Chile
4Servicio de Reumatología, Hospital Provincial de Rosario, Rosario, Argentina
5Servicio de Reumatología, Hospital Privado Universitario de Córdoba, Córdoba, Argentina
6Centro de Investigación Clínica de Morelia, Morelia, Mexico
7Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
8Sección de Inmunología y Reumatología, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno (CEMIC), Buenos Aires, Argentina
9Unidad de Enfermedades Reumáticas y Autoinmunes (UNERA), Corporación Médica Monte Sinaí, Cuenca, Ecuador
10Centro de Reumatología y Rehabilitación, Universidad Espíritu Santo, Guayaquil, Ecuador
11Serviço de Reumatologia, Hospital de Clinicas da Universidade Federal do Paraná, Curitiba, Brazil
12Disciplina de Reumatologia, Departamento de Medicina Interna, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
13Serviço de Reumatologia do Hospital General da Santa Casa da Misericórdia do Rio de Janeiro, Faculdade de Medicina da Universidade Estácio de Sá, Departamento de Medicina Interna da Faculdade de Ciências Médicas da Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
14Rheumatology Unit School of Medical Science, University of Campinas, Campinas, Brazil
15Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
16Centro Paulista de Investigación Clínica, São Paulo, Brazil
17Servicio de Reumatología, Hospital Universidad del Norte, Barranquilla, Colombia
18Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia
19Servicio de Reumatología, Hospital Clínico Quirúrgico Diez de Octubre, Havana, Cuba
20Servicio de Reumatología, Hospital Clínico San Borja-Arriaran, Santiago de Chile, Chile
21Departamento de Reumatología, Consultorio de Especialidades del Instituto Salvadoreño de Seguro Social, San Salvador, El Salvador
22Servicio de Reumatología, Hospital General de México, Ciudad de México, Mexico
23Servicio de Reumatología, Hospital Universitario “Dr. José Eleuterio Gonzalez”, Monterrey, Mexico
24Departamento de Inmunología y Reumatología, Hospital General de Occidente, Universidad de Guadalajara, Guadalajara, Mexico
25Servicio de Reumatología, Hospital Ángeles del Pedregal, Ciudad de México, Mexico
26Servicio de Reumatología, Centro Médico Nacional 20 de Noviembre, Ciudad de México, Mexico
27Hospital México, Caja Costarricense de Seguro Social, Universidad de Costa Rica, San José, Costa Rica
28Médica Uruguaya Corporación de Asistencia Médica (MUCAM), Montevideo, Uruguay
29Complejo Hospitalario Metropolitano Dr. Arnulfo Arias Madrid, Caja de Seguro Social de Panamá, Panama City, Panama
30Servicio de Reumatología, Departamento de Medicina, Hospital Central de San Cristóbal, San Cristóbal, Venezuela
31Department of Medicine, Division of Clinical Immunology and Rheumatology, School of Medicine, The University of Alabama at Birmingham, Birmingham, USA
32Departamento de Medicina Interna, Centro Regional de Enfermedades Autoinmunes y Reumáticas (CREAR), Rosario, Argentina

Tóm tắt

Mục tiêu là xác định các yếu tố dự đoán cơ bản của sự thuyên giảm và hoạt động bệnh thấp (LDA) ở bệnh viêm khớp dạng thấp (RA) giai đoạn đầu từ nhóm GLADAR (Grupo Latino Americano De estudio de la Artritis Reumatoide). Các bệnh nhân có các cuộc hẹn theo dõi 1 và 2 năm đã được đưa vào nghiên cứu. Sự thuyên giảm và LDA được định nghĩa bằng DAS28-ESR (< 2,6 và ≤ 3,2, tương ứng). Các yếu tố dự đoán cơ bản được kiểm tra bao gồm giới tính, dân tộc, tuổi khi chẩn đoán, tình trạng kinh tế-xã hội, thời gian triệu chứng, việc sử dụng DMARDs, RF, tăng tiểu cầu, thiếu máu, cứng khớp buổi sáng, DAS28-ESR (và các thành phần của nó), HAQ-DI, việc sử dụng DMARDs và corticosteroid, và điểm số Sharp-VDH. Các mô hình hồi quy logistic nhị phân đa biến (không bao gồm các thành phần của DAS28-ESR để tránh điều chỉnh quá mức) đã được xây dựng bằng phương pháp chọn lọc lùi (mức α được đặt ở 0,05). Có 498 bệnh nhân đã được đưa vào nghiên cứu. Sự thuyên giảm và LDA/sự thuyên giảm đạt được lần lượt là 19,3% và 32,5% trong cuộc hẹn 1 năm. Đối với 280 bệnh nhân được theo dõi trong 2 năm, các kết quả này đạt được lần lượt là 24,3% và 38,9%. Các yếu tố dự đoán sự thuyên giảm trong 1 năm là DAS28-ESR thấp hơn (OR 1,17; CI 1,07–1,27; p = 0,001) và HAQ-DI (OR 1,48; CI 1,04–2,10; p = 0,028). Trong 2 năm, chỉ có DAS28-ESR (OR 1,40; CI 1,17–1,6; p < 0,001) là một yếu tố dự đoán. Các yếu tố dự đoán LDA/sự thuyên giảm trong 1 năm là DAS28-ESR (OR 1,42; CI 1,26–1,61; p < 0,001), không sử dụng corticosteroid (OR 1,74; CI 1,11–2,44; p = 0,008), và giới tính nam (OR 1,77; CI 1,2–2,63; p = 0,036). DAS28-ESR thấp hơn (OR 1,45; CI 1,23–1,70; p < 0,001) là yếu tố dự đoán duy nhất của LDA/sự thuyên giảm trong 2 năm. Hoạt động bệnh thấp hơn đã liên tục dự đoán sự thuyên giảm và LDA/sự thuyên giảm trong 1 và 2 năm theo dõi ở các bệnh nhân viêm khớp dạng thấp sớm từ nhóm GLADAR.

Từ khóa


Tài liệu tham khảo

Karpouzas GA, Dolatabadi S, Moran R, Li N, Nicassio PM, Weisman MH (2012) Correlates and predictors of disability in vulnerable US Hispanics with rheumatoid arthritis. Arthritis Care Res (Hoboken) 64:1274–1281. https://doi.org/10.1002/acr.21689 Kapetanovic MC, Lindqvist E, Nilsson JA, Saxne T, Eberhardt K (2015) Development of functional impairment and disability in rheumatoid arthritis patients followed for 20 years—relation to disease activity, joint damage and comorbidity. Arthritis Care Res (Hoboken) 67:340–348. https://doi.org/10.1002/acr.22458 Schneeberger EE, Citera G, Maldonado Cocco JA, Salcedo M, Chiardola F, Rosemffet MG, Marengo MF, Papasidero S, Chaparro Del Moral R, Rillo OL, Bellomio V, Lucero E, Spindler A, Berman A, Duartes Noe D, Barreira JC, Lázaro MA, Paira SO (2010) Factors associated with disability in patients with rheumatoid arthritis. J Clin Rheumatol 16:215–218. https://doi.org/10.1097/RHU.0b013e3181e92d25 Smolen JS, Landewé R, Bijlsma J, Burmester G, Chatzidionysiou K, Dougados M, Nam J, Ramiro S, Voshaar M, van Vollenhoven R, Aletaha D, Aringer M, Boers M, Buckley CD, Buttgereit F, Bykerk V, Cardiel M, Combe B, Cutolo M, van Eijk-Hustings Y, Emery P, Finckh A, Gabay C, Gomez-Reino J, Gossec L, Gottenberg JE, Hazes JMW, Huizinga T, Jani M, Karateev D, Kouloumas M, Kvien T, Li Z, Mariette X, McInnes I, Mysler E, Nash P, Pavelka K, Poór G, Richez C, van Riel P, Rubbert-Roth A, Saag K, da Silva J, Stamm T, Takeuchi T, Westhovens R, de Wit M, van der Heijde D (2017) EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update. Ann Rheum Dis 76:960–977. https://doi.org/10.1136/annrheumdis-2016-210715 Singh JA, Furst DE, Bharat A, Curtis JR, Kavanaugh AF, Kremer JM, Moreland LW, O'Dell J, Winthrop KL, Beukelman T, Bridges SL Jr, Chatham WW, Paulus HE, Suarez-Almazor M, Bombardier C, Dougados M, Khanna D, King CM, Leong AL, Matteson EL, Schousboe JT, Moynihan E, Kolba KS, Jain A, Volkmann ER, Agrawal H, Bae S, Mudano AS, Patkar NM, Saag KG (2012) 2012 update of the 2008 American College of Rheumatology recommendations for the use of disease-modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritis. Arthritis Care Res (Hoboken) 64:625–639. https://doi.org/10.1002/acr.21641 da Mota LM, Brenol CV, Palominos P, Pinheiro Gda R (2015) Rheumatoid arthritis in Latin America: the importance of an early diagnosis. Clin Rheumatol 34(Suppl 1):S29–S44. https://doi.org/10.1007/s10067-015-3015-x Cardiel MH (2006) First Latin American position paper on the pharmacological treatment of rheumatoid arthritis. Rheumatology (Oxford) 45(Suppl 2):ii7–ii22. https://doi.org/10.1093/rheumatology/kei500 Pascual-Ramos V, Contreras-Yáñez (2013) Motivations for inadequate persistence with disease modifying anti-rheumatic drugs in early rheumatoid arthritis: the patient’s perspective. BMC Musculoskelet Disord 1:336. https://doi.org/10.1186/1471-2474-14-336 Rodríguez Jaillier JC, Posada Arango AM, Martínez Pérez DA (2015) Challenges faced in Latin America for the implementation of an ideal health-care model for rheumatoid arthritis patients: are we ready? Clin Rheumatol 34(Suppl 1):79–93. https://doi.org/10.1007/s10067-015-3034-7 Burgos Vargas R, Cardiel M (2015) Rheumatoid arthritis in Latin America. Important challenges to be solved. Clin Rheumatol 34(suppl 1):S1–S3. https://doi.org/10.1007/s10067-015-3048-1 Cardiel MH, Pons-Estel BA, Sacnun MP, Wojdyla D, Saurit V, Marcos JC, Pinto MR, Cordeiro de Azevedo AB, da Silveira IG, Radominski SC, Ximenes AC, Massardo L, Ballesteros F, Rojas-Villarraga A, Oñate RV, Hernandez MP, Esquivel-Valerio JA, García-De La Torre I, Khoury VJ, Millán A, Soriano ER (2012) Treatment of early rheumatoid arthritis in a multinational inception cohort of Latin American patients: the GLADAR experience. J Clin Rheumatol 18:327–335. https://doi.org/10.1097/RHU.0b013e31826d6610 Brenol CV, Nava JI, Soriano ER (2015) Proper management of rheumatoid arthritis in Latin America. What the guidelines say? Clin Rheumatol 34(Suppl 1):S 51–S 55. https://doi.org/10.1007/s10067-015-3016-9 Massardo L, Pons-Estel BA, Wojdyla D, Cardiel MH, Galarza-Maldonado CM, Sacnun MP, Soriano ER, Laurindo IM, Acevedo-Vásquez EM, Caballero-Uribe CV, Padilla O, Guibert-Toledano ZM, da Mota LM, Montufar RA, Lino-Pérez L, Díaz-Coto JF, Achurra-Castillo AF, Hernández JA, Esteva-Spinetti MH, Ramírez LA, Pineda C, Furst DE (2012) Early rheumatoid arthritis in Latin America: low socioeconomic status related to high disease activity at baseline. Arthritis Care Res 64:1135–1143. https://doi.org/10.1002/acr.21680 Cardiel MH (2011) Present and future of rheumatic diseases in Latin America. Are we prepared to face them? Reumatol Clin 7:279–280. https://doi.org/10.1016/j.reuma.2010.12.009 Ramagli A, Corbacho I, Linhares F, de Abreu P, Teijeiro R, Garau M (2015) Characteristics of patients with early-onset arthritis in Latin America: description of the REPANARC cohort. J Clin Rheumatol 21:283–288. https://doi.org/10.1097/RHU.0000000000000280 Quintana-Duque MA, Rondon-Herrera F, Mantilla RD, Calvo-Paramo E, Yunis JJ, Varela-Nariño A, Restrepo JF, Iglesias-Gamarra A (2016) Predictors of remission, erosive disease and radiographic progression in a Colombian cohort of early onset rheumatoid arthritis: a 3-year follow-up study. Clin Rheumatol 35:1463–1473. https://doi.org/10.1007/s10067-016-3246-5 Smolen JS, Szumski A, Koenig AS, Jones TV, Marshall L (2018) Predictors of remission with etanercept–methotrexate induction therapy and loss of remission with etanercept maintenance, reduction, or withdrawal in moderately active rheumatoid arthritis: results of the PRESERVE trial. Arthritis Res Ther 20(8):8. https://doi.org/10.1186/s13075-017-1484-9 Uhlig T, Lie E, Norvang V, Lexberg ÅS, Rødevand E, Krøll F, Kalstad S, Olsen IC, Kvien TK (2016) Achievement of remission and low disease activity definitions in patients with rheumatoid arthritis in clinical practice: results from the NOR-DMARD study. J Rheumatol 43:716–723. https://doi.org/10.3899/jrheum.151132 Katchamart W, Johnson S, Lin HJ, Phumethum V, Salliot C, Bombardier C (2010) Predictors for remission in rheumatoid arthritis patients: a systematic review. Arthritis Care Res (Hoboken) 62:1128–1143. https://doi.org/10.1002/acr.20188 Conigliaro P, Triggianese P, Sole Chimenti M, Tonelli M, Sunzini F, Kroegler B, Perricone R (2017) Factors predicting 2 years of remission and low disease activity in rheumatoid arthritis patients treated with TNF-inhibitors. Isr Med Assoc J 19:467–472 Contreras-Yáñez I, Pascual-Ramos V (2015) Window of opportunity to achieve major outcomes in early rheumatoid arthritis patients: how persistence with therapy matters. Arthritis Res Ther 11:177. https://doi.org/10.1186/s13075-015-0697-z Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324 van der Heijde DM (1996) Plain X-rays in rheumatoid arthritis: overview of scoring methods, their reliability and applicability. Baillieres Clin Rheumatol 10:435–453 Mendez Castellano H, de Méndez MC (1994) Sociedad y estratificación: método Graffar-Méndez Castellano. Fundacredesa, Caracas Prevoo ML, van Gestel AM, van T Hof MA, van Rijswijk MH, van de Putte LB, van Riel PL (1996) Remission in a prospective study of patients with rheumatoid arthritis. American Rheumatism Association preliminary remission criteria in relation to the disease activity score. Br J Rheumatol 35:1101–1105 Rannio T, Asikainen J, Hannonen P, Yli-Kerttula T, Ekman P, Pirilä L, Kuusalo L, Mali M, Puurtinen-Vilkki M, Kortelainen S, Paltta J, Taimen K, Kauppi M, Laiho K, Nyrhinen S, Mäkinen H, Isomäki P, Uotila T, Aaltonen K, Kautiainen H, Sokka T (2017) Three out of four disease-modifying anti-rheumatic drug-naïve rheumatoid arthritis patients meet 28-joint disease activity score remission at 12 months: results from the FIN-ERA cohort. Scand J Rheumatol 46:425–431. https://doi.org/10.1080/03009742.2016.1266029 Bird P, Nicholls D, Barrett R, de Jager J, Griffiths H, Roberts L, Tymms K, McCloud P, Littlejohn G (2017) Longitudinal study of clinical prognostic factors in patients with early rheumatoid arthritis: the PREDICT study. Int J Rheum Dis 20:460–446. https://doi.org/10.1111/1756-185X.13036 Hmamouchi I, Combe B, Fautrel B, Rincheval N, Lukas C (2014) Prevalence and concordance of early and sustained remission assessed by various validated indices in the early arthritis “ESPOIR” cohort. Joint Bone Spine 81:409–415. https://doi.org/10.1016/j.jbspin.2014.02.007 Wevers-de Boer K, Visser K, Heimans L, Ronday HK, Molenaar E, Groenendael JH, Peeters AJ, Westedt ML, Collée G, de Sonnaville PB, Grillet BA, Huizinga TW, Allaart CF (2012) Remission induction therapy with methotrexate and prednisone in patients with early rheumatoid and undifferentiated arthritis (the IMPROVED study). Ann Rheum Dis 71:1472–1477. https://doi.org/10.1136/annrheumdis-2011-200736 Aletaha D, Funovits J, Keystone EC, Smolen JS (2007) Disease activity early in the course of treatment predicts response to therapy after one year in rheumatoid arthritis patients. Arthritis Rheum 56:3226–3223. https://doi.org/10.1002/art.22943 Castrejón I, Dougados M, Combe B, Fautrel B, Guillemin F, Pincus T (2016) Prediction of remission in a French early arthritis cohort by RAPID3 and other core data set measures, but not by the absence of rheumatoid factor, anticitrullinated protein antibodies, or radiographic erosions. J Rheumatol 43:1285–1291. https://doi.org/10.3899/jrheum.141586 Choy T, Bykerk VP, Boire G, Haraoui BP, Hitchon C, Thorne C, Keystone EC, Pope JE (2014) Physician global assessment at 3 months is strongly predictive of remission at 12 months in early rheumatoid arthritis: results from the CATCH cohort. Rheumatology (Oxford) 53:482–490. https://doi.org/10.1093/rheumatology/ket366 Saevarsdottir S, Wallin H, Seddighzadeh M, Ernestam S, Geborek P, Petersson IF, Bratt J, van Vollenhoven RF (2011) Predictors of response to methotrexate in early DMARD naive rheumatoid arthritis: results from the initial open-label phase of the SWEFOT trial. Ann Rheum Dis 70:469–475. https://doi.org/10.1136/ard.2010.139212 Mueller RB, Reshiti N, Kaegi T, Finckh A, Haile SR, Schulze-Koops H, Schiff M, Spaeth M, von Kempis J (2017) Does addition of glucocorticoids to the initial therapy influence the later course of the disease in patients with early RA? Results from the Swiss prospective observational registry (SCQM). Clin Rheumatol 36:59–66. https://doi.org/10.1007/s10067-016-3468-6 Konijn NPC, van Tuyl LHD, Boers M, den Uyl D, Ter Wee MM, van der Wijden LKM, Bultink IEM, Kerstens PJSM, Voskuyl AE, van Schaardenburg D, Nurmohamed MT, Lems WF (2017) Similar efficacy and safety of initial COBRA-light and COBRA therapy in rheumatoid arthritis: 4-year results from the COBRA-light trial. Rheumatology (Oxford) 56:1586–1596. https://doi.org/10.1093/rheumatology/kex223 Verschueren P, De Cock D, Corluy L, Joos R, Langenaken C, Taelman V, Raeman F, Ravelingien I, Vandevyvere K, Lenaerts J, Geens GP, Vanhoof J, Durnez, Remans J, Vander Cruyssen B, Van Essche E, Sileghem A, De Brabanter G, Joly J, Van der Elst K, Meyfroidt S, Westhovens R (2015) Patients lacking classical poor prognostic markers might also benefit from a step down glucocorticoid bridging scheme in early rheumatoid arthritis: week 16 results from the randomized multicenter CareRA trial. Arthritis Res Ther 17:97. https://doi.org/10.1186/s13075-015-0611-8 Markusse IM, Akdemir G, Dirven L, Goekoop-Ruiterman YP, van Groenendael JH, Han KH, Molenaar TH, Le Cessie S, Lems WF, van der Lubbe PA, Kerstens PJ, Peeters AJ, Ronday HK, de Sonnaville PB, Speyer I, Stijnen T, Ten Wolde S, Huizinga TW, Allaart CF (2016) Long-term outcomes of patients with recent-onset rheumatoid arthritis after 10 years of tight controlled treatment: a randomized trial. Ann Intern Med 164:523–531. https://doi.org/10.7326/M15-0919 Kuriya B, Xiong J, Boire G, Haraoui B, Hitchon C, Pope J, Thorne JC, Tin D, Keystone EC, Bykerk V (2014) Earlier time to remission predicts sustained clinical remission in early rheumatoid arthritis—results from the Canadian Early Arthritis Cohort (CATCH). J Rheumatol 41:2161–2166. https://doi.org/10.3899/jrheum.140137 Ma MH, Ibrahim F, Walker D, Hassell A, Choy EH, Kiely PD, Williams R, Walsh DA, Young A, Scott DL (2012) Remission in early rheumatoid arthritis: predicting treatment response. J Rheumatol 39:470–475. https://doi.org/10.3899/jrheum.110169 Jayakumar K, Norton S, Dixey J, James D, Gough A, Williams P, Prouse P, Young A (2012) Sustained clinical remission in rheumatoid arthritis: prevalence and prognostic factors in an inception cohort of patients treated with conventional DMARDS. Rheumatology (Oxford) 51:169–175. https://doi.org/10.1093/rheumatology/ker250 Santos-Moreno P, Alvis-Zakzuk NJ, Villarreal-Peralta L, Carrasquilla-Sotomayor M, Paternina-Caicedo A, Alvis-Guzmán N (2018) A comprehensive care program achieves high remission rates in rheumatoid arthritis in a middle-income setting. Experience of a Center of Excellence in Colombia. Rheumatol Int 38:499–505. https://doi.org/10.1007/s00296-017-3903-2 Durez P, Pavelka K, Lazaro MA, Garcia-Kutzbach A, Moots RJ, Amital H, Govoni M, Vastesaeger N (2018) Regional differences in baseline disease activity and remission rates following golimumab treatment for RA: results from the GO-MORE trial. Clin Rheumatol 37:1417–1420. https://doi.org/10.1007/s10067-018-4074-6 Steunebrink LM, Vonkeman HE, ten Klooster PM, Hoekstra M, van Riel PL, van de Laar MA (2016) Recently diagnosed rheumatoid arthritis patients benefit from a treat-to-target strategy: results from the DREAM registry. Clin Rheumatol 35:609–615. https://doi.org/10.1007/s10067-016-3191-3 Albrecht K, Callhoff J, Edelmann E, Schett G, Schneider M, Zink A (2016) Clinical remission in rheumatoid arthritis. Data from the early arthritis cohort study CAPEA. Z Rheumatol 75:90–6. 1. https://doi.org/10.1007/s00393-015-0019-5 Vonkeman HE, Ten Klooster PM, van der Bijl AE, van de Laar MAFJ (2018) Long-term disease and patient-reported outcomes of a continuous treat-to-target approach in patients with early rheumatoid arthritis in daily clinical practice. Clin Rheumatol 37:1189–1197. https://doi.org/10.1007/s10067-017-3962-5 Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd., Birnbaum NS, Burmester GR, Bykerk VP, Cohen MD, Combe B, Costenbader KH, Dougados M, Emery P, Ferraccioli G, Hazes JM, Hobbs K, Huizinga TW, Kavanaugh A, Kay J, Kvien TK, Laing T, Mease P, Ménard HA, Moreland LW, Naden RL, Pincus T, Smolen JS, Stanislawska-Biernat E, Symmons D, Tak PP, Upchurch KS, Vencovský J, Wolfe F, Hawker G (2010) Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 262:2569–2581. https://doi.org/10.1002/art.27584 Einarsson JT, Willim M, Ernestam S, Saxne T, Geborek P, Kapetanovic MC (2019) Prevalence of sustained remission in rheumatoid arthritis: impact of criteria sets and disease duration, a nationwide study in Sweden. Rheumatology (Oxford) 58:227–236. https://doi.org/10.1093/rheumatology/key054 Ichikawa Y, Saito T, Yamanaka H, Akizuki M, Kondo H, Kobayashi S, Oshima H, Kawai S, Hama N, Yamada H, Mimori T, Amano K, Tanaka Y, Matsuoka Y, Yamamoto S, Matsubara T, Murata N, Asai T, Suzuki Y (2010) Clinical activity after 12 weeks of treatment with non-biologics in early rheumatoid arthritis may predict articular destruction 2 years later. J Rheumatol 37:723–729. https://doi.org/10.3899/jrheum.090776 Gremese E, Salaffi F, Bosello SL, Ciapetti A, Bobbio-Pallavicini F, Caporali R, Ferraccioli G (2013) Very early rheumatoid arthritis as a predictor of remission: a multicentre real life prospective study. Ann Rheum Dis 72:858–862. https://doi.org/10.1136/annrheumdis-2012-201456 Barra L, Bykerk V, Pope JE, Haraoui BP, Hitchon CA, Thorne JC, Keystone EC, Boire G (2013) Anticitrullinated protein antibodies and rheumatoid factor fluctuate in early inflammatory arthritis and do not predict clinical outcomes. J Rheumatol 40:1259–1267. https://doi.org/10.3899/jrheum.120736 da Mota LM, Dos Santos Neto LL, de Carvalho JF, Pereira IA, Burlingame R, Ménard HA, Laurindo IM (2012) The presence of anti-citrullinated protein antibodies (ACPA) and rheumatoid factor on patients with rheumatoid arthritis (RA) does not interfere with the chance of clinical remission in a follow-up of 3 years. Reumatol Int 32:3807–3801. https://doi.org/10.1007/s00296-011-2260-9