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RMD open
Par El Hasbani G, Jose George R, J Achenbach S et 3 autres.
Contenu en anglais
To report population-level data describing long-term trends in remission, sustained remission and relapse among patients with rheumatoid arthritis (RA).
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We conducted a population-based inception cohort study of adults with incident RA in Olmsted County, Minnesota, USA, meeting 1987 or 2010 ACR criteria between 1990 and 2019. Patients were followed through 31 December 2023. We estimated cumulative incidence of first remission, sustained remission (≥6 months) and relapse after remission, accounting for competing risk of death. Cox models comparing calendar periods were adjusted for age, sex, baseline body mass index and serostatus.
Among 1179 patients followed for a median of 9.4 years, 816 achieved remission and 630 achieved sustained remission. One-year remission, defined by our prespecified criteria, increased from 12.8% in 1990–1999 to 26.4% in 2010–2019. Median time to remission shortened from 6.4 years to 2.8 years. Despite these gains, relapse within 5 years after remission increased from 62.8% in 1990–1999 vs 79.2% in the 2010–2023 period.
Remission in RA has become earlier and more frequent over time, but durability has not improved. Strategies to sustain remission remain a critical unmet need.
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