Mercado U

Language: Spanish
References: 14
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ABSTRACT

Objective: To determine, in patients with early rheumatoid arthritis, the frequency of remission at 6 and 12 months with synthetic and conventional disease-modifying drugs in three age groups.
Materials and Methods: Prospective study conducted (between 2014 and 2018) in patients with a diagnosis of early rheumatoid arthritis, with more or less 12 months of symptom duration and ACR-EULAR disease classification criteria (2010). All received combined treatment with disease-modifying drugs, conventional synthetic, including methotrexate if not contraindicated; in addition, 2.5 to 5.0 mg per day of prednisone, which was indicated as a bridge while disease-modifying drugs achieved symptom reduction.
Results: There were studied 259 patients; 84% of the sample were women. On admission, all had active disease according to the Clinical Disease Activity Index and DAS28, with high titers of ACPA (79%) and 62.5% of rheumatoid factor. There were 54 patients who were negative for ACPA less than 17 U/mL and positive for rheumatoid factor. Patients with titers greater than 17 U/mL had activity greater than 22 on the Clinical Disease Activity Index and DAS28. Eighty percent of cases had an Acute Disability Questionnaire score greater or less than 1.0. At six months, remission was higher in the young and middle-aged than in the elderly (82% vs. 67%, p = 0.03 and 88% vs. 67%, p = 0.0001). At 12 months, there was no statistical difference between the groups (93%, 84%, and 98%, p = 0.07 and p = 0.08, respectively). Hand radiographs showed no bone erosions. The HAQ score decreased at six months. All 259 patients completed the follow-up.
Conclusions: To achieve disease remission, treatment should be started early until minimal activity is achieved. There was no difference in remission between groups at 12 months. In the absence of biologics, conventional synthetic disease-modifying drugs and patient adherence achieve a better disease prognosis.

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