Choice of and response to treatment in patients with early-diagnosed rheumatoid arthritis: Real-world data from an inception cohort in Japan (NICER-J).

Various guidelines recommend that patients with early rheumatoid arthritis (RA) try to achieve clinical remission within 6 months, and early therapeutic intervention is important to this end. This study aimed to investigate short-term treatment outcomes of patients with early-diagnosed RA in clinical practice and to examine predictive factors for achieving remission. Of the 210 patients enrolled in the multicenter RA inception cohort, 172 patients who were followed up to 6 months after treatment initiation (baseline) were included. Logistic regression analysis was used to examine the impact of baseline characteristics on achievement of Boolean remission at 6 months. Participants (mean age, 62 years) initiated treatment after a mean of 19 days from RA diagnosis. At baseline and 3 and 6 months after treatment initiation, proportions of patients using methotrexate (MTX) were 87.8%, 89.0%, and 88.3%, respectively, and rates of Boolean remission were 1.8%, 27.8%, and 34.5%, respectively. Multivariate analysis revealed that physician global assessment (PhGA) (Odds ratio (OR): 0.84, 95% confidence interval (CI): 0.71-0.99) and glucocorticoid use (OR: 0.26, 95% CI: 0.10-0.65) at baseline were independent factors that predicted Boolean remission at 6 months. After a diagnosis of RA, satisfactory therapeutic effects were achieved at 6 months after the initiation of treatment centered on MTX according to the treat to target strategy. PhGA and glucocorticoid use at treatment initiation are useful for predicting the achievement of treatment goals.

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Copyright © 2023 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest MS has received speakers' fees from Eli Lilly, AbbVie, Asahi Kasei, Daiichi Sankyo, Janssen Pharmaceutical, Bristol-Myers Squibb, Chugai Pharmaceutical, and Pfizer Japan. SA has received speakers' fees from AbbVie, Asahi Kasei, Astellas, Bristol-Myers Squibb, Chugai, Eli Lilly, Pfizer, and Sanofi. RH has received speakers' fees from AbbVie and Eisai. ET has received speakers' fees from AbbVie, Asahi Kasei, Bristol-Myers Squibb, Chugai, Daiichi-Sankyo, Eisai, Eli Lilly, Janssen, Mitsubishi Tanabe, Pfizer, Takeda, and UCB Japan. KT has received speakers' fees from Asahi Kasei. NT has received research support and/or speakers’ fees from AbbVie, Bristol-Myers Squibb, Chugai, Eisai, Mitsubishi Tanabe, Asahi Kasei, Astellas, Pfizer, Janssen, Daiichi-Sankyo, Takeda, Eli Lilly, Novartis, and UCB Japan. TK received research support from Eli-Lilly Japan and Astellas Pharma, a research grant from AbbVie, and lecture fees from Tanabe Mitsubishi Pharma, Eisai Pharma, AbbVie, Bristol-Myers Squibb, Daiichi-Sankyo, Pfizer, Eli-Lilly Japan, Gilead Sciences, Ayumi Pharmaceutical, Asahi Kasei, Astellas Pharma, and Chugai Pharma.