Greater likelihood of remission in @entity309 XXXX treated earlier in the disease course: results from the Consortium of Rheumatology Researchers of North America registry.

@entity1 @entity39 @entity5 @entity2874 @entity309
OBJECTIVE: To examine whether disease duration is an independent predictor of achieving remission in @entity309 ( @entity309 ) @entity1 initiating therapy. METHODS: @entity309 @entity1 in the Consortium of Rheumatology Researchers of North America registry newly prescribed a nonbiologic disease-modifying antirheumatic drug (DMARD) or anti-- @entity5 @entity39 factor (anti- @entity2874 ) with at least one followup visit were identified. Achievement of remission was defined using the Clinical Disease Activity Index (CDAI; score  <=2.8) and 28-joint Disease Activity Score (DAS28; score <2.6) at any followup visit within one year; sustained remission was defined as remission during any two successive visits. Likelihood of remission was examined through logistic regression based on 5-year increments of disease duration, adjusting for baseline covariates. RESULTS: Among the 1,646 nonbiologic DMARD initiators, CDAI remission occurred in 21.3% of those with  <=5 years of disease duration, 19.6% with 6-10 years, and 13.5% with >= 11 years (P < 0.001); sustained remission occurred in 10.2%, 8.8%, and 2.5%, respectively (P < 0.001). Results were similar among the 3,179 anti- @entity2874 initiators (CDAI remission in 22.3%, 17.7%, and 12.8%, respectively [P < 0.001]; CDAI sustained remission in 9.7%, 9.5%, and 4.2%, respectively [P < 0.001]). DAS28 results were similar in both groups. In adjusted analyses, an increase of disease duration by 5 years was associated with a reduced likelihood of CDAI remission in nonbiologic DMARD (odds ratio [OR] 0.91, 95% confidence interval [95% CI] 0.83-0.99) and anti- @entity2874 initiators (OR 0.88, 95% CI 0.83-0.94). A similar result was seen for sustained remission using the CDAI (nonbiologic DMARD: OR 0.61, 95% CI 0.48-0.76; anti- @entity2874 : OR 0.85, 95% CI 0.75-0.97). CONCLUSION: Earlier treatment was associated with a greater likelihood of remission.
