Simplified disease activity changes in real-world practice: a nationwide observational study of seropositive rheumatoid arthritis patients with moderate-to-high disease activity

Kichul Shin, Sung Soo Kim, Sang Heon Lee, Seung Jae Hong, Sung Jae Choi, Jung Yoon Choe, Seung Geun Lee, Hoon Suk Cha, Eun Young Lee, Sung Hwan Park, Jin Wuk Hur, Sung Soo Na, Chang Hee Suh, Min Wook So, Seung Won Choi, Dong Hyuk Sheen, Won Park, Shin Seok Lee, Wan Hee Ryu, Jin Seok KimJung Soo Song, Hye Soon Lee, Seong Ho Kim, Dae Hyun Yoo

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Abstract

Background/Aims: The objective of this study was to compare changes in the simplified disease activity index (SDAI) between biologic (b) and conventional (c) disease-modifying antirheumatic drugs (DMARD) users with seropositive rheumatoid arthritis (RA) in daily clinical practice. Methods: This was a nationwide multicenter observational study. Patients who had three or more active joint counts and abnormal inf lammatory marker in blood test were enrolled. The selection of DMARDs was determined by the attending rheumatologist. Clinical parameters, laboratory findings, and Health Assessment Questionnaire (HAQ) scores were obtained at baseline and at 6 and 12 months. Serial SDAI changes and clinical remission rate at 6 and 12 months were assessed. Results: A total of 850 patients participated in this study. The mean baseline SDAI score in bDMARD group was higher than that in cDMARD group (32.08 ± 12.98 vs 25.69 ± 10.97, p < 0.0001). Mean change of SDAI at 12 months was –19.0 in the bDMARD group and –12.6 in the cDMARD group (p < 0.0001). Clinical remission rates at 12 months in bDMARD and cDMARD groups were 15. 4% and 14.6%, respectively. Patient global assessment and HAQ at 12 months were also significantly improved in both groups. Multivariate logistic regression showed that baseline HAQ score was the most notable factor associated with remission. Conclusions: There was a significant reduction in SDAI within 12 months after receiving DMARDs in Korean seropositive RA patients irrespective of bDMARD or cDMARD use in real-world practice. Clinical remission was achieved in those with lower baseline HAQ scores.

Original languageEnglish
Pages (from-to)231-239
Number of pages9
JournalKorean Journal of Internal Medicine
Volume35
Issue number1
DOIs
StatePublished - 1 Jan 2020

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Keywords

  • Antirheumatic agents
  • Arthritis
  • Biological therapy
  • Rheumatoid

Cite this

Shin, K., Kim, S. S., Lee, S. H., Hong, S. J., Choi, S. J., Choe, J. Y., Lee, S. G., Cha, H. S., Lee, E. Y., Park, S. H., Hur, J. W., Na, S. S., Suh, C. H., So, M. W., Choi, S. W., Sheen, D. H., Park, W., Lee, S. S., Ryu, W. H., ... Yoo, D. H. (2020). Simplified disease activity changes in real-world practice: a nationwide observational study of seropositive rheumatoid arthritis patients with moderate-to-high disease activity. Korean Journal of Internal Medicine, 35(1), 231-239. https://doi.org/10.3904/kjim.2018.137