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For patients with early rheumatoid arthritis (RA) managed with a treat-to-target strategy, achievement of sustained remission at two years is associated with higher remission rates and better physical function at 10 years, according to a study published online Oct. 15 in Annals of the Rheumatic Diseases.

Lena Bugge Nordberg, M.D., Ph.D., from Diakonhjemmet Hospital in Norway, and colleagues enrolled 230 patients from the ARCTIC trial with early RA to examine whether achievement of sustained remission is associated with favorable long-term outcomes. A strict treat-to-target strategy was applied for two years; participants were invited to a 10-year follow-up, including assessment of disease activity, radiographic damage, physical function, and survival.

Overall, 218 of the patients were alive at 10 years and 179 (82%) participated in the follow-up study. The researchers found that at 10 years after diagnosis, 82% of patients were in disease activity score (DAS) remission. Limited radiographic progression was seen, with a median change of 2.0 in the total van der Heijde-modified Sharp score from baseline to 10 years.

Substantial improvement was seen in physical function and health-related quality of life, approaching population norms. Comparable survival was seen to that of the general population. Lower disease activity and higher physical function were seen at the 10-year follow-up for patients who achieved sustained DAS remission at two years versus those who did not.

"The results support current treatment recommendations for RA and offer reassurance to patients newly diagnosed with RA that clinical remission, preserved function, and favorable long-term survival are realistic long-term outcomes," the authors write.

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