Two-year results of disease activity score (DAS)-remission-steered treatment strategies aiming at drug-free remission in early arthritis patients (the IMPROVED-study)

Table 2 Outcomes in the IMPROVED-study population after 2 years

	Total n = 610	Early remission n = 387	Arm 1 n = 83	Arm 2 n = 78	P value arm 1 vs 2	OOP n = 50
DAS, mean ± SD	1.5 ± 0.8	1.3 ± 0.8	2.0 ± 0.7	1.9 ± 0.9	0.45	1.9 ± 0.7
HAQ, mean ± SD	0.5 ± 0.6	0.4 ± 0.5	0.9 ± 0.7	0.8 ± 0.7	0.55	0.8 ± 0.7
Swollen joint count, median (IQR)	0 (0–1)	0 (0–1)	1 (0–2)	0 (0–2)	0.25	0 (0–2)
Tender joint count, median (IQR)	1 (0–3)	0 (0–2)	3 (2–5)	3 (1–6)	0.84	2 (1–4)
ESR mm/h, median (IQR)	9 (5–17)	8 (4–16)	11 (6–20)	9 (6–17)	0.19	14 (7–25)
VAS global health (mm), mean ± SD	22 ± 22	18 ± 21	30 ± 21	28 ± 24	0.61	32 ± 22
Total SHS, median (IQR)	0 (0–0.5)	0 (0–0.5)	0 (0–1.1)	0 (0–0)	0.12	0 (0–0.3)
Erosive, n (%)	50 (8)	39 (10)	2 (2)	8 (10)	0.04	1 (2)
SHS progression, n (%)	50 (8)	33 (9)	9 (11)	5 (6)	0.31	3 (6)
DAS-remission, n (%)	301 (49)	241 (62)	22 (27)	24 (31)	0.76	14 (28)
Drug-free remission, n (%)	131 (22)	111 (29)	6 (7)	7 (9)	0.73	7 (14)
ACR/EULAR remission, n (%)	138 (23)	117 (30)	2 (2)	14 (18)	0.001	5 (10)

After 4 months 12 patients were lost to follow up and 598 patients were categorized. Arm 1: randomized after 4 months to methotrexate, sulphasalazine, hydroxychloroquine and low-dose prednisone. Arm 2: randomized after 4 months to methotrexate and adalimumab. OOP outside of protocol, SD standard deviation, IQR interquartile range, n number, DAS disease activity score, HAQ health assessment questionnaire, ESR erythrocyte sedimentation rate, VAS visual analogue scale, SHS Sharp-van de Heijde score, Erosive at least 1 erosion, Progression increase in SHS ≥0.5 points, DAS-remission DAS <1.6 [24], ACR/EULAR remission provisional Boolean-based remission definition published by the American College of Rheumatology and the European League Against Rheumatism based on a 44-joint count [26]

ISSN: 1478-6362