Remission of rheumatoid arthritis and potential determinants: a national multi-center cross-sectional survey

• DOI: 10.1007/s10067-014-2828-3
• Publication Date: 2014-11-21T15:04:25Z
• Authors: Guan-Ying Wang; Sa-Li Zhang; Xiu-Ru Wang; Min Feng; Chun Li; Yuan An; Xiao- Feng Li; Li-Zhi Wang; Cai-Hong Wang; Yong-Fu Wang; Rong Yang; Hui-Ming Yan; Guo-Chun Wang; Xin Lu; Xia Liu; Ping Zhu; Li-Na Chen; Hong-Tao Jin; Jin-Ting Liu; Hui-Fang Guo; Hai-Ying Chen; Jian-Li Xie; Ping Wei; Jun-Xiang Wang; Xiang-Yuan Liu; Lin Sun; Liu-Fu Cui; Rong Shu; Bai-Lu Liu; Ping Yu; Zhuo-Li Zhang; Guang-Tao Li; Zhen-Bin Li; Jing Yang; Jun-Fang Li; Bin Jia; Feng-Xiao Zhang; Jie-Mei Tao; Jin-Ying Lin; Mei-Qiu Wei; Xiao-Min Liu; Dan Ke; Shao-Xian Hu; Cong Ye; Shu-Ling Han; Xiu-Yan Yang; Hao Li; Ci-Bo Huang; Ming Gao; Bei Lai; Yong-Jing Cheng; Xing-Fu Li; Li-Jun Song; Xiao-Xia Yu; Ai-Xue Wang; Li-Jun Wu; Yan-Hua Wang; Lan He; Wen-Wen Sun; Lu Gong; Xiao-Yuan Wang; Yi Wang; Yi Zhao; Xiao-Xia Li; Yan Wang; Yan Zhang; Yin Su; Chun-Fang Zhang; Rong Mu; Zhan-Guo Li
• Keywords: Rheumatism; Hydroxychloroquine; Cross-sectional study; Youden's J statistic; Univariate analysis; Rheumatoid factor

The aim of this study is to investigate the remission rate of rheumatoid arthritis (RA) in China and identify its potential determinants. A multi-center cross-sectional study was conducted from July 2009 to January 2012. Data were collected by face-to-face interviews of the rheumatology outpatients in 28 tertiary hospitals in China. The remission rates were calculated in 486 RA patients according to different definitions of remission: the Disease Activity Score in 28 joints (DAS28), the Simplified Disease Activity Index (SDAI), the Clinical Disease Activity Index (CDAI), and the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) Boolean definition. Potential determinants of RA remission were assessed by univariate and multivariate analyses. The remission rates of RA from this multi-center cohort were 8.6% (DAS28), 8.4% (SDAI), 8.2% (CDAI), and 6.8% (Boolean), respectively. Favorable factors associated with remission were: low Health Assessment Questionnaire (HAQ) score, absence of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP), and treatment of methotrexate (MTX) and hydroxychloroquine (HCQ). Younger age was also predictive for the DAS28 and the Boolean remission. Multivariate analyses revealed a low HAQ score, the absence of anti-CCP, and the treatment with HCQ as independent determinants of remission. The clinical remission rate of RA patients was low in China. A low HAQ score, the absence of anti-CCP, and HCQ were significant independent determinants for RA remission.