Global assessments of disease activity are age-dependent determinant factors of clinical remission in rheumatoid arthritis

Abstract

Global assessment of disease activity was age-dependent and independent of joint counts, and it provides a critical determinant of clinical non-remission.

Reply

“…Although we described the median RA duration as 31 months (range 0-608 months), we should have clearly stated that 11 of 50 patients enrolled in that study were treatmentnaive. Therefore, MTX was received at the time of study enrollment by 27 of the remaining 39 patients (69%), which was comparable to that in our recent cross-sectional study of 304 patients (median age 71 years) with RA, in which Simplified Disease Activity Index (SDAI) remission was observed in 49.7% of patients, and current MTX use was observed in 63.5% of patients overall (62.3% in patients with SDAI remission, and 64.7% in those without SDAI remission) (1).…”

Reply

“…Although we described the median RA duration as 31 months (range 0–608 months), we should have clearly stated that 11 of 50 patients enrolled in that study were treatment‐naive. Therefore, MTX was received at the time of study enrollment by 27 of the remaining 39 patients (69%), which was comparable to that in our recent cross‐sectional study of 304 patients (median age 71 years) with RA, in which Simplified Disease Activity Index (SDAI) remission was observed in 49.7% of patients, and current MTX use was observed in 63.5% of patients overall (62.3% in patients with SDAI remission, and 64.7% in those without SDAI remission) .…”

Hubungan Antara Parameter Klinis Dan Laboratoris Dengan Status Remisi Penyakit Pada Pasien Artritis Reumatoid Yang Mendapat Terapi Metotreksat

“…Penelitian Castrejon, Ito, dan Verstappen juga mendapatkan pengukuran VAS pada awal penyakit merupakan prediktor terjadinya remisi pada pasien AR yang mendapat terapi metotreksat, di mana pasien dengan nyeri hebat pada awal penyakit kurang bisa mencapai remisi. [18][19][20] Tingginya kontribusi dari nyeri ini disebabkan banyak faktor dan berhubungan kuat dengan status inflamasi. Sitokin proinflamasi seperti TNF dan IL-6 dapat mempengaruhi ambang nyeri melalui sensitisasi jangka panjang pada reseptor nyeri di sendi sehingga menyebabkan nyeri kronis.…”

“…Penelitian Ito, Verstappen, dan Bird juga menunjukkan hubungan yang bermakna antara LED dan remisi, di mana kadar LED dasar yang tinggi merupakan prediktor untuk sulitnya terjadi remisi. 19,20,22 Penelitian lain juga ada yang mendapatkan hasil yang kontradiktif, misalnya Drouin dan Ma tidak menemukan hubungan bermakna antara LED pada aktivitas penyakit pasien, termasuk juga remisi. LED yang tinggi menandakan tingkat inflamasi yang tinggi pula, sehingga menyebabkan lebih sulit untuk mencapai remisi.…”