Dissertation (Masters) The Impact of Achieving Low Disease Activity in the First Year of the Disease on Future Disability and Damage in Patients with Early Rheumatoid Arthritis


Pooneh Seyed-Akhavan


Aim: To describe the predictive validity of reaching low disease activity (LDA) at 1 year on future disability and joint damage in patients with early rheumatoid arthritis (ERA).

Methods: First a systematic literature review of prognostic studies assessing the association between disease activity and functional or radiographic outcomes in ERA was performed. Then data from the Study Of New-Onset RA (SONORA) were used to evaluate the impact of year-one LDA on 3-year disability and 2-year radiographic progression using multivariate regression analyses.

Results: Our review demonstrated evidence for relationship between baseline disease activity and future disability and join damage. However evidence for the impact of early treatment response on long-term outcomes in ERA is sparse. Analysis of 984 patients showed year one LDA predicts lower HAQ (p less than .0001) and less damage (p=0.04) in future.

Conclusion: Reaching LDA early is associated with better long-term functional and radiographic outcomes in patients with early RA.