Izabela Domyslawska, Gindzienska-Sieskiewicz Ewa, Chrostowski Tomek, Klimiuk A. Piotr and Sierakowski Stanislaw
Objectives: The process of medication for patients with Rheumatoid arthritis until the moment of remission is well-described. However, there is a lack of detailed recommendations as to how to proceed from that point on.
Methods: Our trial produced data for analysis of durability of remission with discontinued biological drugs. We used data from patients treated in the Department of Rheumatology in Bialystok. Patient’s ≥ 18 years with a diagnosis of severe active RA. Patients received biological treatment according to Polish National Health Service guidelines and were monitored every 3 months.
Results: 141 patients met the sample selection criteria. The median time of first-line therapy in our study was 378.5 days. Secondary failure of initial response to treatment was observed in 5.67% of the patients. 118 patients (83.68%) responded to treatment with first-line biological DMARD, the median time to achieve remission or low disease activity - was 198 days. DAS28 remission was achieved in approximately 54% of patients, and low disease activity was obtained in 29% of patients. In this group the median time to discontinuation of treatment was 452.4 day. After discontinuation of therapy relapse occurred in 104 of 139 patients (74.28%). Disease recurrence within 12 months after the end of treatment was observed in an average 110.4 days. The time to reach the next remission in this group of patients was on average 211 days. A proportion of patients who achieved remission and low disease activity with respect to first-line treatment was significantly lower (33% compared to 49%).