International journal of rheumatic diseases · 2025
Chinese Registry of Rheumatoid Arthritis (CREDIT) VI: Temporal Trends in Patients With Early Rheumatoid Arthritis and Moderate-To-Severe Disease Activity - A Multicenter Cohort Study of Treatment Strategies and Outcomes.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Deng Yafang, Qiao Lin, Li Hongbin, Yu Chen, Jin Shangyi, Wang Jing, Zou Qinghua, Wu Lijun, Duan Xinwang, Xu Jian, Mo Hanyou, Jiang Zhenyu, Jiang Nan, Wang Yanhong, Zeng Xiaofeng, Li Mengtao, Wang Qian, Tian Xinping, CREDIT Co‐authors
Аннотация
AIM: The continuous update of international guidelines and enhanced availability of biological disease-modifying antirheumatic drugs (bDMARDs) and targeted synthetic DMARDs (tsDMARDs) have made a significant impact on the diagnosis and treatment of early rheumatoid arthritis (ERA). This study aims to systematically evaluate the current treatment strategies and outcomes within a large-scale cohort of patients with ERA.
METHODS: Data from the Chinese Registry of Rheumatoid Arthritis (CREDIT), a large multicenter Chinese registry of RA, were collected to analyze temporal trends in clinical profiles, therapeutic strategies, and treatment outcomes among patients with ERA.
RESULTS: From November 2016 to October 2023, A total of 2722 patients with follow-up information for 6 months were included. The use of methotrexate (MTX) increased annually and has become the predominant DMARD as the initial treatment. Following initial therapy, 1059 (38.9%) patients achieved the therapeutic target of low disease activity and remission. Age ≥ 50 years (adjusted OR 0.70 [95% CI 0.59-0.83]; p < 0.001), high baseline disease activity (adjusted OR 0.48 [95% CI 0.41-0.57]; p < 0.001), csDMARD monotherapy other than MTX (adjusted OR 0.55 [95% CI 0.41-0.73]; p < 0.001), and the use of b/tsDMARDs without a csDMARD combination (adjusted OR 0.57 [95% CI 0.36-0.87]; p = 0.011) were associated with lower target attainment rates. For patients who did not achieve the treatment target after initial therapy, the use of b/tsDMARDs increased after 2020, although the extent of therapeutic escalation remained suboptimal.
CONCLUSION: Treatment of patients with ERA in China has become more standardized. Adherence to guideline-directed therapeutic regimens has emerged as a significant determinant of therapeutic target achievement. The increased prevalence of b/tsDMARDs would benefit more patients in ameliorating the disease.
METHODS: Data from the Chinese Registry of Rheumatoid Arthritis (CREDIT), a large multicenter Chinese registry of RA, were collected to analyze temporal trends in clinical profiles, therapeutic strategies, and treatment outcomes among patients with ERA.
RESULTS: From November 2016 to October 2023, A total of 2722 patients with follow-up information for 6 months were included. The use of methotrexate (MTX) increased annually and has become the predominant DMARD as the initial treatment. Following initial therapy, 1059 (38.9%) patients achieved the therapeutic target of low disease activity and remission. Age ≥ 50 years (adjusted OR 0.70 [95% CI 0.59-0.83]; p < 0.001), high baseline disease activity (adjusted OR 0.48 [95% CI 0.41-0.57]; p < 0.001), csDMARD monotherapy other than MTX (adjusted OR 0.55 [95% CI 0.41-0.73]; p < 0.001), and the use of b/tsDMARDs without a csDMARD combination (adjusted OR 0.57 [95% CI 0.36-0.87]; p = 0.011) were associated with lower target attainment rates. For patients who did not achieve the treatment target after initial therapy, the use of b/tsDMARDs increased after 2020, although the extent of therapeutic escalation remained suboptimal.
CONCLUSION: Treatment of patients with ERA in China has become more standardized. Adherence to guideline-directed therapeutic regimens has emerged as a significant determinant of therapeutic target achievement. The increased prevalence of b/tsDMARDs would benefit more patients in ameliorating the disease.