Background: The aim of treatment in rheumatoid arthritis (RA) is to prevent articular damage and functional loss by decreasing the activity of the disease. The overall goal full suppression of the activity of the disease, also called as remission. In RA, some patients step into remission with treatment and some do it spontaneously. There is little work on remission rates and relevant factors in RA.
Objectives: The aim of this study was to determine the frequency of remission in rheumatoid arthritis (RA), and to identify features associated with remission.
Methods: Retrospective study of patients with RA seen at a single center between 1996-2000. Patients had at least one year of follow-up. Remission was defined according to ACR criteria at least in last two consecutive visits. Patients were classified according to remission status as remission or non-remission. A detailed chart review was undertaken to determine demographic characteristics, history and initial manifestation and laboratory testing results of RA.
Results: Among 240 patients with RA 105 patients fulfilled the inclusion criteria. Remission was established in 32 patients (30.4%). The ratio of male patients in remission group was greater than the ratio of female patients (34.3% vs. 16.4%), but this difference was not statistically significant. Initial Steinbrocker grades were higher in non-remission patients (p=0.039). Anemia (p=0.002) and the high levels of ESR (p=0.001) at the time of diagnosis were also more common in non-remission group. However, neither previous history, gender, duration of the disease, rheumatoid factor, rheumatoid nodule nor the age at the onset of the disease was associated with remission.
Conclusion: Anemia and the high levels of ESR at disease onset and the initial Steinbrocker grade may predict the probability of non-remission in most patients. Some clinical and laboratory characteristics of patients at their first clinic visit may be associated with future remissions.