A longitudinal analysis of prevalence of sustained remission and low disease activity in rheumatoid arthritis patients treated with anti-tumour necrosis factor: an analysis of the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis

Background: Attainment of remission or low disease activity (LDA) are recommended targets for rheumatoid arthritis (RA) treatment, and associated with improved functional and radiographic long-term outcomes. However, evidence reporting the prevalence of sustained remission/LDA is sparse. This study examines how often sustained remission/LDA occurs, and how this outcome has changed between 2001 and 2013 in patients with RA treated with anti-tumour necrosis factor (TNF) using data from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis (BSRBR-RA).Methods: Data were included on all RA patients treated with their first anti-TNF agent between 2001 and 2013 and censored following discontinuation of anti-TNF/switching biologic. The cohort was split into subgroups: patients commenced on anti-TNF between 2001-2010 and 2010-2013. Changes in prevalence of sustained remission/LDA were examined. Sustained remission/LDA was defined as a DAS28-ESR score of ≤ 2.6/≤3.2 for ≥6 months while on anti-TNF treatment. Data were censored at 3 years. Multiple imputation was used for missing data.