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Vol. 18. Issue 10.
Pages 574-579 (December 2022)
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Vol. 18. Issue 10.
Pages 574-579 (December 2022)
Original article
Clinical Advantage of Attaining Index-Based Remission Prior to Composite Remission in Treating Rheumatoid Arthritis
Ventaja clínica de lograr la remisión basada en índices antes que la remisión compuesta en el tratamiento de la artritis reumatoide
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Ichiro Yoshiia,
Corresponding author
, Tatsumi Chijiwab, Naoya Sawadac
a Department of Rheumatology and Musculoskeletal Medicine, Yoshii Hospital, Shimanto City, Kochi Prefecture, Japan
b Department of Rheumatology, Kochi Memorial Hospital, Kochi, Kochi, Japan
c Department of Rheumatology, Dohgo Onsen Hospital, Matsuyama, Ehime Prefecture, Japan
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Abstract
Background and objectives

The clinical advantage of targeting index-based remission prior to Boolean remission was evaluated retrospectively.

Materials and methods

A total of 578 patients with rheumatoid arthritis (RA), who were treated for more than three years, were recruited. Patients who were treated to targeted index-based remission and composite measure remission criteria such as Boolean remission from the first consultation were divided according to the turn of attaining Boolean remission and index-based remission: G-IBR, a group that matched index-based remission at the same time Boolean remission is attained or earlier; G-BR_IF, a group that attained Boolean remission followed by index-based remission or failed; G-IR_BF, a group that could not attain Boolean remission despite attaining index-based remission; G-BothF, a group that failed to attain either Boolean remission or index-based remission. Background factors were statistically compared among groups. The Boolean remission rate in patients who attained index-based remission (BRR) and the rate of failure to attain index-based remission in patients who failed to attain Boolean remission (BFR) were statistically evaluated.

Results

Groups comprising 225, 231, and 482 in G-IBR; 160, 154, and 8 in G-BR_IF; 18, 18, and 75 in G-IR_BF; and 175, 175, and 13 in G-BothF when indexing the clinical disease activity index (CDAI), simplified disease activity index (SDAI), and 28-joints disease activity score with C-reactive protein (DAS28-CRP), respectively. Disease activity indices’ scores after Boolean remission were demonstrated to be significantly higher in the G-BR_IF group than in the G-IBR group. BRR was 92.6%, 92.8%, and 86.5%, while BFR was 71.3%, 71.3%, and 13.8% when indexing CDAI, SDAI, and DAS28-CRP, respectively.

Conclusions

Targeting CDAI and SDAI remission prior to Boolean remission contributes to a stable clinical course.

Keywords:
Rheumatoid arthritis
Remission
ADL
Therapeutic index
Resumen
Antecedentes y objetivos

Se evaluó prospectivamente la ventaja clínica de centrarse en la remisión basada en índices de manera previa a la remisión booleana.

Materiales y métodos

Se seleccionó a un total de 578 pacientes con artritis reumatoide que habían sido tratados durante más de 3 años. Se dividió en grupos a los pacientes según los criterios de remisión: remisión basada en índices o remisión de medidas compuestas, tales como remisión booleana desde la primera consulta, de acuerdo con el plazo de logro: G-IBR, un grupo que equiparó la remisión basada en índices al mismo tiempo que logró la remisión booleana o antes; G-BR_IF, un grupo que logró la remisión booleana seguida de remisión basada en índices o que fracasó; G-IR_BF, un grupo que no logró la remisión booleana a pesar de lograr la remisión basada en índices; G-BothF, un grupo que no logró la remisión booleana ni la remisión basada en índices. Se compararon entre los grupos los factores antecedentes. Se evaluaron estadísticamente la tasa de remisión booleana en los pacientes que lograron la remisión basada en índices (BRR) y la tasa de fracaso en el logro de la remisión booleana (BFR).

Resultados

Los grupos estuvieron formados por 225, 231 y 482 en G-IBR; 160, 154 y 8 en G-BR_IF; 18, 18 y 75 en G-IR_BF y 175, 175 y 13 en G-BothF al indexar el índice de actividad de la enfermedad clínica (CDAI), el índice simplificado de actividad de la enfermedad (SDAI) y el índice DAS-28 con proteína C reactiva (DAS28-CRP), respectivamente. Las puntuaciones de los índices de actividad de la enfermedad tras la remisión booleana fueron significativamente más altas en el grupo G-BR_IF que en el grupo G-IBR. BRR fue del 92,6; 92,8 y 86,5%, mientras que BFR fue del 71,3; 71,3 y 13,8% al indexar CDAI, SDAI y DAS28-CRP, respectivamente.

Conclusiones

Centrarse en las remisiones CDAI y SDAI de forma previa a la remisión booleana contribuye a un curso clínico estable.

Palabras clave:
Artritis reumatoide
Remisión
ADL
Índice terapéutico

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