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KMID : 0338420200350010231
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Korean Journal of Internal Medicine
2020 Volume.35 No. 1 p.231 ~ p.239
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Simplified disease activity changes in real-world practice: a nationwide observational study of seropositive rheumatoid arthritis patients with moderate-to-high disease activity
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Shin Ki-Chul
Kim Sung-Soo
Lee Sang-Heon
Hong Seung-Jae
Choi Sung-Jae
Choe Jung-Yoon
Lee Seung-Geun
Cha Hoon-Suk
Lee Eun-Young
Park Sung-Hwan
Hur Jin-Wuk
Na Sung-Soo
Suh Chang-Hee
So Min-Wook
Choi Seung-Won
Sheen Dong-Hyuk
Park Won
Lee Shin-Seok
Ryu Wan-Hee
Kim Jin-Seok
Song Jung-Soo
Lee Hye-Soon
Kim Seong-Ho
Yoo Dae-Hyun
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Abstract
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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.
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KEYWORD
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Arthritis, rheumatoid, Antirheumatic agents, Biological therapy
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