Reduction of long-term disability in XXXX by early and persistent @entity32 : results from the Norfolk Arthritis Register.

@entity1 @entity32
OBJECTIVE: To test the predictive ability of remission in terms of long-term disability in @entity1 with recent-onset @entity32 ( @entity32 ). METHODS: Consecutive @entity1 with early @entity32 , recruited between 1990 and 1994 (first cohort) and 2000 and 2004 (second cohort), were included in this study. Remission was defined as the absence of clinically detectable joint @entity32 on a 51-joint count. In additional analyses, less stringent definitions of remission were used based on the 40- and 28-joint counts. Remission was assessed at 1, 2, and 3 years after inclusion. A 5-year Health Assessment Questionnaire score >=  1 (moderate disability) was chosen as the primary outcome measure. RESULTS: A total of 841 and 498 @entity1 from the first and second cohorts, respectively, completed 5 years of followup. In the first cohort, @entity1 with at least 1 episode of remission had lower odds of 5-year disability (odds ratio [OR] 0.26, 95% confidence interval [95% CI] 0.17-0.41). The number of times in remission correlated with the odds of disability, with a mean decrease in the probability of disability of ~64% for each additional time point in remission (OR 0.38, 95% CI 0.28-0.52). The time until first remission was not associated with functional disability. Remission according to less stringent criteria showed a weaker protection against future disability. Similar results were found in the second cohort. CONCLUSION: @entity1 with @entity32 achieving a state of sustained remission early are less likely to show long-term deterioration of function compared with @entity1 who do not achieve remission. The most persistent remission under the most stringent definition of remission has the lowest probability of long-term disability.
