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Clin Rheumatol. 2018 Mar;37(3):597-605. doi: 10.1007/s10067-017-3850-z. Epub 2017 Nov 7.

Remission assessment of rheumatoid arthritis in daily practice in China: a cross-sectional observational study.

Zhu H1,2,3, Li R1,2,3, Da Z4, Bi L5, Li X6, Li Y7, Liu C8, Zhang F9, Li Z10, Liu X11, Zhang Z12, Sun L13, Wang Y14, Zhang W15, Jiang Q16, Chen J17, Chen Q18, Li Z19, Wu L20, Qi W21, Xu J22, Cui X23, Wang X24, Li L25, Leng X26, Wang G27, Zhao D28, Jiang L29, He D30, Liu X31, Li L32, Fang Y33, Huang C34, Wu H35, Hu S36, Li Q37, Song H38, Xiao W39, Gong L40, Zhang L41, Li X42, Li Z43,44,45, Su Y46,47,48.

Author information

1
Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, China.
2
Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis (BZ0135), Beijing, China.
3
Peking-Tsinghua Center for Life Sciences, Beijing, China.
4
Affiliated Hospital of Nantong University, Nantong, Jiangsu Sheng, China.
5
China-Japan Union Hospital of Jilin University, Changchun, Jilin, China.
6
Anhui Provincial Hospital, Hefei, China.
7
The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
8
Daping Hospital, Research Institute of Surgery, Third Military Medical University, Chongqing, China.
9
Hebei General Hospital, Shijiazhuang, Hebei Sheng, China.
10
The First Affiliated Hospital of Bengbu Medical College, Bengbu, China.
11
Peking University Third Hospital, Beijing, China.
12
The First Affiliated Hospital of Harbin Medical University, Harbin, China.
13
Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
14
Jiangxi Provincial People's Hospital, Nanchang, Jiangxi, China.
15
The Fifth Department of Rheumatology, Xi'an No. 5 Hospital, Xi'an, China.
16
Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
17
The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
18
The First Department of Rheumatology, Xi'an No.5 Hospital, Xi'an, China.
19
Bethune International Peace Hospital, Shijiazhuang, China.
20
People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang, China.
21
Tianjing First Center Hospital, Tianjin, China.
22
The First Affiliated Hospital of Anhui Medical University, Hefei, China.
23
Yichang Central People's Hospital, Yichang, China.
24
Shengjing Hospital of China Medical University, Shenyang, China.
25
The Affiliated Hospital of Guiyang Medical University, Guiyang, China.
26
Peking Union Medical College Hospital, Beijing, China.
27
China-Japan Friendship Hospital, Beijing, China.
28
Changhai Hospital, Shanghai, China.
29
Zhongshan Hospital, Shanghai, China.
30
Guanghua Hospital, Shanghai, China.
31
The Hospital of Shunyi District Beijing, Shunyi District, China.
32
Tianjin People's Hospital, Tianjin, China.
33
South West Hospital, Third Military Medical University, Chongqing, China.
34
Beijing Hospital, Beijing, China.
35
The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China.
36
Tongji Hospital, Tongji Medical College of Hust, Tongji College Huazhong University Science & Technology, Wuhan, China.
37
The First People's Hospital of Yunnan Province, Kunming, China.
38
Beijing Jishuitan Hospital, Beijing, China.
39
The First Hospital of China Medical University, Shenyang, China.
40
Tianjing Medical University General Hospital, Beijing, China.
41
Jiangsu Province Hospital, Nanjing, China.
42
The Second Hospital of Shanxi Medical University, Taiyuan, China.
43
Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, China. li99@bjmu.edu.cn.
44
Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis (BZ0135), Beijing, China. li99@bjmu.edu.cn.
45
Peking-Tsinghua Center for Life Sciences, Beijing, China. li99@bjmu.edu.cn.
46
Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, China. suyin0921@163.com.
47
Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis (BZ0135), Beijing, China. suyin0921@163.com.
48
Peking-Tsinghua Center for Life Sciences, Beijing, China. suyin0921@163.com.

Abstract

The objective of this study is to evaluate the remission rate and describe the current use of medication in a large cohort of rheumatoid arthritis (RA) patients under routine clinical care in China. RA patients were recruited from 40 large teaching hospitals nationwide in China. Data regarding RA disease activity, medication treatment, and adverse events were recorded using a standardized clinical data questionnaire. RA remission was evaluated by the 28 Joint Disease Activity Score DAS28-ESR Clinical Disease Activity Index (CDAI), Simplified Disease Activity Index (SDAI), and American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) remission criteria. A total of 1945 patients with RA were included in the study. The proportions of patients who fulfilled the DAS28-ESR, CDAI, SDAI, and ACR/EULAR remission criteria were 10.90%, 6.17%, 5.04% , and 1.75%, respectively. Most patients had taken at least one disease-modifying anti-rheumatic drug (DMARD), and the most common prescriptions included leflunomide (LEF) and methotrexate (MTX). DMARD combined with botanics were the most common and dominant strategy for RA management (29.16%). Overall, 433 patients (22.27%) had at least one adverse event. Gastrointestinal adverse events (41.27%) were the most frequently reported events. The incidence of side effects in patients using biologics DMARDs (bDMARDs) was significantly lower than that in those taking MTX, LEF, or sulfasalazine (SSZ). The remission rate of RA disease activity, as assessed in Chinese clinical practice, was very low. Adverse effects of the medicine occurred in approximately one in five RA patients, with bDMARDs were demonstrated to be the medication with the lowest side effects.

KEYWORDS:

Adverse events; DMARDs; Disease activity; Medical options; Rheumatoid arthritis

PMID:
29116543
DOI:
10.1007/s10067-017-3850-z
[Indexed for MEDLINE]

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