Characteristics and prevalence of clinical remission of rheumatoid arthritis in a nationwide study from Indonesia

Suryana, Bagus Putu Putra and Hidayat, Rudy and Sarmidi, Sumariyono and Wibowo, Suryo Anggoro Kusumo and Hamijoyo, Laniyati and Rahmadi, Andri Reza and Marpaung, Blondina and Ginting, Andi Raga and Kambayana, Gede and Kurniari, Pande Ketut and Sylvawani, Mahriani and Najirman, Najirman and Suarjana, Nyoman and Achadiono, Deddy Nur Wachid and Rahmawati, Lita Diah and Awalia, Awalia and Suntoko, Bantar and Warlisti, Ika Vemilia and Nurudhin, Arief and Prabowo, Nurhasan Agung and Partan, Radiyati Umi and Reagan, Muhammad and Adnan, Endy and Ongkowijaya, Jeffrey Arthur and Akil, Natsir and Pratama, Mirza Zaka (2024) Characteristics and prevalence of clinical remission of rheumatoid arthritis in a nationwide study from Indonesia. International Journal of Rheumatic Diseases, 27 (2): e15050.. ISSN 17561841

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Abstract

Aim: To investigate the clinical characteristics, DMARD treatment pattern, remission rate, and factors associated with disease remission of rheumatoid arthritis (RA) patients in Indonesia. Method: A multicenter survey was conducted in 2019–2020 involving 16 hospitals in Indonesia. Inclusion criteria were RA patients who fulfilled the 2010 ACR/EULAR classification criteria, were aged ≥18 years, and have been treated with 1 DMARD or more for at least 6 months, with exclusion criteria being the co-existence of other autoimmune diseases or pain syndromes. Disease activities and remission rate were defined using DAS28-ESR. Results: A total of 870 patients were completed for analysis. Remission was achieved in 24.5 of patients, while low disease activity in 18.5, moderate disease activity in 44.6, and high disease activity in 12.4. The distribution of conventional DMARDs from subjects was methotrexate 69.9, leflunomide 15.9, sulfasalazine 12.0, chloroquine/hydroxychloroquine 8.9, and cyclosporine 4.8. Patients treated with biologic DMARDs were only 0.3. The mean methotrexate dose was 11.2 ± 4.0 mg/week, and the mean methotrexate duration was 45.1 ± 36.6 months. The majority of patients received glucocorticoids (65.5). 71.1 received DMARD monotherapy, while 28.9 had combined DMARDs. According to the multivariate analysis, delayed time to diagnosis and treatment (>6 months), DMARD monotherapy, and glucocorticoid use were negatively associated with disease remission. Conclusion: The remission rate of Indonesian RA patients is 24.5, and low disease activity is 18.5. Methotrexate and leflunomide are the most frequent conventional DMARDs used. Delayed diagnosis, delayed treatment, and DMARD monotherapy contributed to the current low remission rate in Indonesia. © 2024 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

Item Type: Article
Additional Information: Cited by: 2
Uncontrolled Keywords: chloroquine; cyclic citrullinated peptide antibody; disease modifying antirheumatic drug; glucocorticoid; hydroxychloroquine; leflunomide; methotrexate; methylprednisolone; rheumatoid factor; salazosulfapyridine; adult; Article; autoimmune disease; body mass; DAS28; delayed diagnosis; disease activity; disease duration; educational status; erythrocyte sedimentation rate; female; human; major clinical study; male; monotherapy; multicenter study; observational study; prevalence; remission; retrospective study; rheumatoid arthritis; smoking; therapy delay; visual analog scale
Subjects: R Medicine > RN Non Surgical Divisions
R Medicine > RC Internal medicine
Divisions: Faculty of Medicine, Public Health and Nursing > Non Surgical Divisions
Depositing User: Ngesti Gandini
Date Deposited: 18 Mar 2025 02:58
Last Modified: 18 Mar 2025 02:58
URI: https://ir.lib.ugm.ac.id/id/eprint/15808

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