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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThis article discusses results from the French Early Arthritis (ESPOIR) cohort study. Investigators analyzed patients who were in remission to determine if a patient\u0027s global status assessment and fatigue rating during the first year of early arthritis play a significant role in predicting structural progression over 3 years.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EArthritis Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003ELaure Gossec, MD, PhD, Paris Descartes University, Paris, France, presented results from the French Early Arthritis (ESPOIR) cohort study. Investigators analyzed patients who were in remission to determine if a patient\u0027s global status assessment and fatigue rating during the first year of early arthritis play a significant role in predicting structural progression over 3 years.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EESPOIR is an observational study of patients with early arthritis who had no prior disease-modifying antirheumatic drug (DMARD) therapy. Early arthritis was defined as having at least 2 swollen joints for \u0026lt;6 months. The outcome was change in total Sharp-van der Heijde score (SHS) from baseline to 3 years, adjusted for baseline radiographic score. Predictive variables included definitions of remission at 6 and 12 months, swollen and tender joints, C-reactive protein (CRP), global assessment, and fatigue rating (means of 6- and 12-month values). Remission definitions that were used were the ACR\/EULAR Boolean remission (tender and swollen joint counts \u22641, CRP \u22641 mg\/dL, and patient global \u22641\/10), no-patient-reported outcome (PRO) near-remission (remission for all criteria except patient global), and fatigue remission (\u22641\/10 on a visual analog scale). Kappa agreement statistics were used to compare the definitions of remission. Multiple linear regression was used for prediction by remission definitions. Multiple linear regression and stepwise selection were used for prediction of radiographic score by remission components. Analyses were restricted to patients with all relevant data, with no imputation of missing data.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003ERemission data were available for 776 patients, and complete data were available for 520 patients. Among the patients with complete data, after 3 years, DAS28 decreased from 5.2\u00b11.3 to 2.9\u00b11.4, HAQ score decreased from 1.0\u00b10.7 to 0.5\u00b10.6, global assessment (0 to 10) decreased from 6.0\u00b12.5 to 2.9\u00b12.6, fatigue rating (0 to 10) decreased from 4.8\u00b12.8 to 3.4\u00b12.0, and SHS radiographic total score increased from 5.4\u00b17.7 to 13.6\u00b114.7. At 3 years, 57% of the patients were receiving methotrexate, and 16% were receiving biologic therapies.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EOf the 776 patients, 7.4% achieved ACR\/EULAR remission, 18.7% achieved no-PRO near remission, and 3.1% achieved fatigue remission (ie, with a fatigue score lower than 1\/10). Of the 520 patients, 6.7% achieved ACR\/EULAR remission, 18.7% achieved no-PRO near remission, and 3.1% achieved fatigue remission. Agreement between ACR\/EULAR and the other remission definitions was moderate: ACR\/EULAR versus no-PRO near remission \u2013 kappa, 0.48 (95% CI, 0.37 to 0.58); ACR\/EULAR versus fatigue remission \u2013 kappa, 0.41 (95% CI, 0.23 to 0.58).\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EIn the comparison of the remission models for the prediction of radiographic score, only swollen joint count and CRP were predictive of radiographic score. The PROs were not significant. Additional analysis of global cutoff in patients in no-PRO near remission (n=97) demonstrated no correlation between patient global and radiographic progression (Spearman correlation 0.025; p=0.575).\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EThis analysis had several limitations. The comparison of models was not straightforward. There was a potential lack of power because of the low number of patients in remission. Fatigue remission is not a feasible outcome with a cutoff of 1\/10.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003ENo-PRO near remission was more frequent than ACR\/EULAR Boolean remission in patients with early arthritis (18.7% vs 6.7%). Fatigue remission was rare (3.1%). Swollen joint count and acute-phase reactants were strong drivers of radiographic progression. Patients\u0027 global assessments had limited additional predictive value for radiographic progression. Further research is warranted.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2012 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/12\/9\/16.2.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzng4p\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}