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- Title
Treatment discontinuation in patients with very early rheumatoid arthritis in sustained simplified disease activity index remission after synthetic disease-modifying anti-rheumatic drug administration.
- Authors
Kita, Junko; Tamai, Mami; Arima, Kazuhiko; Nakashima, Yoshikazu; Suzuki, Takahisa; Kawashiri, Shin-ya; Iwamoto, Naoki; Okada, Akitomo; Koga, Tomohiro; Yamasaki, Satoshi; Nakamura, Hideki; Origuchi, Tomoki; Ida, Hiroaki; Aoyagi, Kiyoshi; Uetani, Masataka; Eguchi, Katsumi; Kawakami, Atsushi
- Abstract
We aimed to identify whether drug-free remission could be achieved in patients with very early rheumatoid arthritis (RA) with poor prognosis factors by treatment with synthetic disease-modifying antirheumatic drugs (DMARDs). Thirteen patients with very early RA, whose disease was considered to have highly erosive potential, were included. Magnetic resonance imaging (MRI)-proven bone edema and autoantibodies were determined in these patients. A treat-to-target strategy initiated with synthetic DMARDs was employed for 12 months. If the patients achieved simplified disease activity index (SDAI) remission along with a reduction of the RA MRI scoring bone edema score to <33% as compared with baseline at 12 months, DMARD treatment was stopped and the clinical status was further observed for the following 12 months. Synthetic DMARDs were stopped at 12 months in 5 patients. One of the 5 was lost to follow-up because of sustaining an injury that required orthopedic surgery. Three of the remaining 4 patients showed continued SDAI remission that was DMARD-free without any evidence of radiographic progression for the following 12 months. Although this was a small clinical trial, we have shown-for the first time-that true remission of very early RA with poor prognosis factors can be achieved by treatment with synthetic DMARDs.
- Subjects
RHEUMATOID arthritis; ANTIRHEUMATIC agents; DRUG administration; MAGNETIC resonance imaging; AUTOANTIBODIES; CLINICAL trials; FOLLOW-up studies (Medicine)
- Publication
Modern Rheumatology, 2012, Vol 22, Issue 3, p346
- ISSN
1439-7595
- Publication type
Article
- DOI
10.3109/s10165-011-0522-8