Achieving simplified disease activity index remission in patients with active rheumatoid arthritis is associated with subsequent good functional and structural outcomes in a real-world clinical setting under a treat-to-target strategy

Fumio Hirano, Waka Yokoyama, Hayato Yamazaki, Koichi Amano, Atsushi Kawakami, Taichi Hayashi, Naoto Tamura, Shinsuke Yasuda, Hiroaki Dobashi, Takao Fujii, Satoshi Ito, Yuko Kaneko, Toshihiro Matsui, Yasuaki Okuda, Kazuyoshi Saito, Fumihito Suzuki, Ryusuke Yoshimi, Ryoko Sakai, Ryuji Koike, Hitoshi KohsakaNobuyuki Miyasaka, Masayoshi Harigai

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective: To verify predictive validity of simplified disease activity index (SDAI) remission for subsequent functional and structural outcomes in real-world clinical settings under a treat-to-target strategy (T2T). Methods: In this multicenter, prospective cohort study, T2T was implemented in rheumatoid arthritis (RA) patients with moderate-to-high disease activity. SDAI or clinical disease activity index (CDAI) was assessed every 12 weeks, and treatment was adjusted to achieve clinical remission or low disease activity (LDA). Multivariate logistic regression models were used to examine the associations of SDAI remission (≤3.3) at week 24 with the health assessment questionnaire-disability index (HAQ-DI) ≤ 0.5 or with the delta van der Heijde-modified total Sharp score (ΔvdH-mTSS) <smallest detectable change (SDC) at week 72. Results: Of 318 patients enrolled, 271 completed the follow-up for 72 weeks and were subjects of the analyses. Factors [odds ratio (95% confidence interval)] significantly associated with the HAQ-DI ≤0.5 were SDAI remission at week 24 [2.99 (1.42–6.28), p = 0.004], baseline HAQ-DI [0.28 (0.18–0.45), p = 1.3 × 10−7], and baseline vdH-mTSS [0.986 (0.976–0.996), p = 0.009]. A factor associated with ΔvdH-mTSS < SDC was SDAI remission at week 24 [3.53 (1.62–7.71), p = 0.002]. Conclusion: Predictive validity of SDAI remission for good outcomes was verified in a T2T-implementing cohort in the current clinical settings.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalModern Rheumatology
DOIs
Publication statusAccepted/In press - 2016 Dec 19

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Rheumatoid Arthritis
Health
Logistic Models
Cohort Studies
Odds Ratio
Prospective Studies
Confidence Intervals
Surveys and Questionnaires

Keywords

  • Health assessment questionnaire
  • Modified Sharp score
  • Rheumatoid arthritis
  • Simplified disease activity index
  • Treat-to-target

ASJC Scopus subject areas

  • Rheumatology

Cite this

Achieving simplified disease activity index remission in patients with active rheumatoid arthritis is associated with subsequent good functional and structural outcomes in a real-world clinical setting under a treat-to-target strategy. / Hirano, Fumio; Yokoyama, Waka; Yamazaki, Hayato; Amano, Koichi; Kawakami, Atsushi; Hayashi, Taichi; Tamura, Naoto; Yasuda, Shinsuke; Dobashi, Hiroaki; Fujii, Takao; Ito, Satoshi; Kaneko, Yuko; Matsui, Toshihiro; Okuda, Yasuaki; Saito, Kazuyoshi; Suzuki, Fumihito; Yoshimi, Ryusuke; Sakai, Ryoko; Koike, Ryuji; Kohsaka, Hitoshi; Miyasaka, Nobuyuki; Harigai, Masayoshi.

In: Modern Rheumatology, 19.12.2016, p. 1-9.

Research output: Contribution to journalArticle

Hirano, F, Yokoyama, W, Yamazaki, H, Amano, K, Kawakami, A, Hayashi, T, Tamura, N, Yasuda, S, Dobashi, H, Fujii, T, Ito, S, Kaneko, Y, Matsui, T, Okuda, Y, Saito, K, Suzuki, F, Yoshimi, R, Sakai, R, Koike, R, Kohsaka, H, Miyasaka, N & Harigai, M 2016, 'Achieving simplified disease activity index remission in patients with active rheumatoid arthritis is associated with subsequent good functional and structural outcomes in a real-world clinical setting under a treat-to-target strategy', Modern Rheumatology, pp. 1-9. https://doi.org/10.1080/14397595.2016.1265726
Hirano, Fumio ; Yokoyama, Waka ; Yamazaki, Hayato ; Amano, Koichi ; Kawakami, Atsushi ; Hayashi, Taichi ; Tamura, Naoto ; Yasuda, Shinsuke ; Dobashi, Hiroaki ; Fujii, Takao ; Ito, Satoshi ; Kaneko, Yuko ; Matsui, Toshihiro ; Okuda, Yasuaki ; Saito, Kazuyoshi ; Suzuki, Fumihito ; Yoshimi, Ryusuke ; Sakai, Ryoko ; Koike, Ryuji ; Kohsaka, Hitoshi ; Miyasaka, Nobuyuki ; Harigai, Masayoshi. / Achieving simplified disease activity index remission in patients with active rheumatoid arthritis is associated with subsequent good functional and structural outcomes in a real-world clinical setting under a treat-to-target strategy. In: Modern Rheumatology. 2016 ; pp. 1-9.
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abstract = "Objective: To verify predictive validity of simplified disease activity index (SDAI) remission for subsequent functional and structural outcomes in real-world clinical settings under a treat-to-target strategy (T2T). Methods: In this multicenter, prospective cohort study, T2T was implemented in rheumatoid arthritis (RA) patients with moderate-to-high disease activity. SDAI or clinical disease activity index (CDAI) was assessed every 12 weeks, and treatment was adjusted to achieve clinical remission or low disease activity (LDA). Multivariate logistic regression models were used to examine the associations of SDAI remission (≤3.3) at week 24 with the health assessment questionnaire-disability index (HAQ-DI) ≤ 0.5 or with the delta van der Heijde-modified total Sharp score (ΔvdH-mTSS) −7], and baseline vdH-mTSS [0.986 (0.976–0.996), p = 0.009]. A factor associated with ΔvdH-mTSS < SDC was SDAI remission at week 24 [3.53 (1.62–7.71), p = 0.002]. Conclusion: Predictive validity of SDAI remission for good outcomes was verified in a T2T-implementing cohort in the current clinical settings.",
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AU - Hirano, Fumio

AU - Yokoyama, Waka

AU - Yamazaki, Hayato

AU - Amano, Koichi

AU - Kawakami, Atsushi

AU - Hayashi, Taichi

AU - Tamura, Naoto

AU - Yasuda, Shinsuke

AU - Dobashi, Hiroaki

AU - Fujii, Takao

AU - Ito, Satoshi

AU - Kaneko, Yuko

AU - Matsui, Toshihiro

AU - Okuda, Yasuaki

AU - Saito, Kazuyoshi

AU - Suzuki, Fumihito

AU - Yoshimi, Ryusuke

AU - Sakai, Ryoko

AU - Koike, Ryuji

AU - Kohsaka, Hitoshi

AU - Miyasaka, Nobuyuki

AU - Harigai, Masayoshi

PY - 2016/12/19

Y1 - 2016/12/19

N2 - Objective: To verify predictive validity of simplified disease activity index (SDAI) remission for subsequent functional and structural outcomes in real-world clinical settings under a treat-to-target strategy (T2T). Methods: In this multicenter, prospective cohort study, T2T was implemented in rheumatoid arthritis (RA) patients with moderate-to-high disease activity. SDAI or clinical disease activity index (CDAI) was assessed every 12 weeks, and treatment was adjusted to achieve clinical remission or low disease activity (LDA). Multivariate logistic regression models were used to examine the associations of SDAI remission (≤3.3) at week 24 with the health assessment questionnaire-disability index (HAQ-DI) ≤ 0.5 or with the delta van der Heijde-modified total Sharp score (ΔvdH-mTSS) −7], and baseline vdH-mTSS [0.986 (0.976–0.996), p = 0.009]. A factor associated with ΔvdH-mTSS < SDC was SDAI remission at week 24 [3.53 (1.62–7.71), p = 0.002]. Conclusion: Predictive validity of SDAI remission for good outcomes was verified in a T2T-implementing cohort in the current clinical settings.

AB - Objective: To verify predictive validity of simplified disease activity index (SDAI) remission for subsequent functional and structural outcomes in real-world clinical settings under a treat-to-target strategy (T2T). Methods: In this multicenter, prospective cohort study, T2T was implemented in rheumatoid arthritis (RA) patients with moderate-to-high disease activity. SDAI or clinical disease activity index (CDAI) was assessed every 12 weeks, and treatment was adjusted to achieve clinical remission or low disease activity (LDA). Multivariate logistic regression models were used to examine the associations of SDAI remission (≤3.3) at week 24 with the health assessment questionnaire-disability index (HAQ-DI) ≤ 0.5 or with the delta van der Heijde-modified total Sharp score (ΔvdH-mTSS) −7], and baseline vdH-mTSS [0.986 (0.976–0.996), p = 0.009]. A factor associated with ΔvdH-mTSS < SDC was SDAI remission at week 24 [3.53 (1.62–7.71), p = 0.002]. Conclusion: Predictive validity of SDAI remission for good outcomes was verified in a T2T-implementing cohort in the current clinical settings.

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