Inflammation and biologic therapy in patients with rheumatoid arthritis achieving versus not achieving ACR/EULAR Boolean remission in a treat-to-target study
OBJECTIVE: To investigate limiting factors of American College of Rheumatology (ACR)/EULAR Boolean remission in rheumatoid arthritis (RA), and compare patients who fulfil the criteria to patients who only partly fulfil the criteria, with respect to imaging inflammation and biologic disease modifying...
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ftpubmed:oai:pubmedcentral.nih.gov:8804675 2023-05-15T15:11:19+02:00 Inflammation and biologic therapy in patients with rheumatoid arthritis achieving versus not achieving ACR/EULAR Boolean remission in a treat-to-target study Paulshus Sundlisæter, Nina Sundin, Ulf Aga, Anna-Birgitte Sexton, Joseph Hammer, Hilde Berner Uhlig, Till Kvien, Tore K Haavardsholm, Espen A Lillegraven, Siri 2022-01-28 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8804675/ http://www.ncbi.nlm.nih.gov/pubmed/35091463 https://doi.org/10.1136/rmdopen-2021-002013 en eng BMJ Publishing Group http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8804675/ http://www.ncbi.nlm.nih.gov/pubmed/35091463 http://dx.doi.org/10.1136/rmdopen-2021-002013 © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . CC-BY-NC RMD Open Rheumatoid Arthritis Text 2022 ftpubmed https://doi.org/10.1136/rmdopen-2021-002013 2022-02-13T01:32:49Z OBJECTIVE: To investigate limiting factors of American College of Rheumatology (ACR)/EULAR Boolean remission in rheumatoid arthritis (RA), and compare patients who fulfil the criteria to patients who only partly fulfil the criteria, with respect to imaging inflammation and biologic disease modifying anti-rheumatic drug (DMARD) usage. METHODS: Patients with DMARD-naïve RA were treated according to current recommendations in the the ARCTIC trial (Aiming for Remission in rheumatoid arthritis: a randomised trial examining the benefit of ultrasound in a Clinical TIght Control regimen). Limiting factors of reaching ACR/EULAR Boolean remission at 2 years were assessed. Imaging inflammation (ultrasound and MRI) in patients in remission was compared with patients failing to fulfil different components of the criteria. The OR of biologic therapy was calculated using logistic regression. RESULTS: Of 203 patients, 112 (55%) reached ACR/EULAR Boolean remission; 49 (24%) fulfilled three of four criteria. The main limiting factors were patient global assessment (PGA) (59%) and tender joints (22%). Imaging inflammation was not significantly different for patients in remission and patients not fulfilling the criteria due to elevated PGA and/or tender joints, but higher odds of using biologics (OR 3.63, 95% CI 1.73 to 7.61) were observed. CONCLUSIONS: PGA and tender joints were the factors most often limiting achievement of ACR/EULAR Boolean remission. The level of imaging inflammation was not elevated in these patients compared with patients in remission, but the odds of using biologic DMARDs were higher. Text Arctic PubMed Central (PMC) Arctic RMD Open 8 1 e002013 |
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Rheumatoid Arthritis |
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Rheumatoid Arthritis Paulshus Sundlisæter, Nina Sundin, Ulf Aga, Anna-Birgitte Sexton, Joseph Hammer, Hilde Berner Uhlig, Till Kvien, Tore K Haavardsholm, Espen A Lillegraven, Siri Inflammation and biologic therapy in patients with rheumatoid arthritis achieving versus not achieving ACR/EULAR Boolean remission in a treat-to-target study |
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Rheumatoid Arthritis |
description |
OBJECTIVE: To investigate limiting factors of American College of Rheumatology (ACR)/EULAR Boolean remission in rheumatoid arthritis (RA), and compare patients who fulfil the criteria to patients who only partly fulfil the criteria, with respect to imaging inflammation and biologic disease modifying anti-rheumatic drug (DMARD) usage. METHODS: Patients with DMARD-naïve RA were treated according to current recommendations in the the ARCTIC trial (Aiming for Remission in rheumatoid arthritis: a randomised trial examining the benefit of ultrasound in a Clinical TIght Control regimen). Limiting factors of reaching ACR/EULAR Boolean remission at 2 years were assessed. Imaging inflammation (ultrasound and MRI) in patients in remission was compared with patients failing to fulfil different components of the criteria. The OR of biologic therapy was calculated using logistic regression. RESULTS: Of 203 patients, 112 (55%) reached ACR/EULAR Boolean remission; 49 (24%) fulfilled three of four criteria. The main limiting factors were patient global assessment (PGA) (59%) and tender joints (22%). Imaging inflammation was not significantly different for patients in remission and patients not fulfilling the criteria due to elevated PGA and/or tender joints, but higher odds of using biologics (OR 3.63, 95% CI 1.73 to 7.61) were observed. CONCLUSIONS: PGA and tender joints were the factors most often limiting achievement of ACR/EULAR Boolean remission. The level of imaging inflammation was not elevated in these patients compared with patients in remission, but the odds of using biologic DMARDs were higher. |
format |
Text |
author |
Paulshus Sundlisæter, Nina Sundin, Ulf Aga, Anna-Birgitte Sexton, Joseph Hammer, Hilde Berner Uhlig, Till Kvien, Tore K Haavardsholm, Espen A Lillegraven, Siri |
author_facet |
Paulshus Sundlisæter, Nina Sundin, Ulf Aga, Anna-Birgitte Sexton, Joseph Hammer, Hilde Berner Uhlig, Till Kvien, Tore K Haavardsholm, Espen A Lillegraven, Siri |
author_sort |
Paulshus Sundlisæter, Nina |
title |
Inflammation and biologic therapy in patients with rheumatoid arthritis achieving versus not achieving ACR/EULAR Boolean remission in a treat-to-target study |
title_short |
Inflammation and biologic therapy in patients with rheumatoid arthritis achieving versus not achieving ACR/EULAR Boolean remission in a treat-to-target study |
title_full |
Inflammation and biologic therapy in patients with rheumatoid arthritis achieving versus not achieving ACR/EULAR Boolean remission in a treat-to-target study |
title_fullStr |
Inflammation and biologic therapy in patients with rheumatoid arthritis achieving versus not achieving ACR/EULAR Boolean remission in a treat-to-target study |
title_full_unstemmed |
Inflammation and biologic therapy in patients with rheumatoid arthritis achieving versus not achieving ACR/EULAR Boolean remission in a treat-to-target study |
title_sort |
inflammation and biologic therapy in patients with rheumatoid arthritis achieving versus not achieving acr/eular boolean remission in a treat-to-target study |
publisher |
BMJ Publishing Group |
publishDate |
2022 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8804675/ http://www.ncbi.nlm.nih.gov/pubmed/35091463 https://doi.org/10.1136/rmdopen-2021-002013 |
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Arctic |
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RMD Open |
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8804675/ http://www.ncbi.nlm.nih.gov/pubmed/35091463 http://dx.doi.org/10.1136/rmdopen-2021-002013 |
op_rights |
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
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CC-BY-NC |
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https://doi.org/10.1136/rmdopen-2021-002013 |
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RMD Open |
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