Psychosocial burden predicts sustained remission in early rheumatoid arthritis

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Despite the early use of disease-modifying antirheumatic drugs and implementation of treat-to-target strategies, disabling symptoms persist in many patients with early RA. Interestingly, the symptom triad, including pain, fatigue, and physical functioning, has been shown to be a better predictor of remission in patients with early RA than laboratory tests and imaging studies.

The current study demonstrated the association that exists between psychosocial well-being and sustained disease remission in patients with early RA.

Data were obtained from the Care in Early RA trial.

Sustained remission was defined as a Disease Activity Score in 28 joints-CRP < 2.6 from week 16 to week 104.

Illness perception was assessed using the following instruments at baseline and week 16: Short Form 36 (SF-36) health survey; Revised Illness Perception Questionnaire (IPQ-R); and the Utrecht Coping List.

Sub-groups of remission were identified at week 16 using the Latent Profile Analysis.

Patients with sustained remission had higher SF-36 scores, lower passive coping at baseline, and more positive IPQ-R scores at week 16. Of those patients in remission at week 16 (n=287), 231 had a low psychosocial burden and longer remission (HR = 0.51).