Chinese Registry of Rheumatoid Arthritis (CREDIT): III. the Transition of Disease Activity During Follow-Ups and Predictors of Achieving Treatment Target.

Aim The Chinese Registry of Rheumatoid Arthritis (CREDIT) is the first nationwide multi-center prospective rheumatoid arthritis (RA) registration cohort in China. This study aimed at presenting disease activities transition during follow-ups and identifying predictors to treatment response. Method Patients who had baseline, 3- and 6-month follow-up data from November 2016 to April 2018 were recruited. Then, we selected patients who did not reach remission (REM)/low disease activity (LDA) at baseline to investigate the predictors for treatment response. Results There were 979 patients included (83.00% female, mean age 51.8 and median duration 3.84 years). REM/LDA rate at baseline, 3-, and 6-month follow-up were 34.02%, 59.35% and 68.23%. Additionally, early RA has more chance to achieve targets than established RA (6 months: 59.79% vs 48.13%,P = .002). High baseline Disease Activity Score of 28 joints (DAS28) (early RA: odds ratio [OR] 1.319,P = .019; established RA: OR 1.337,P < .001), biologic disease-modifying anti-rheumatic drugs (bDMARD)/targeted synthetic DMARD combined conventional DMARD therapy (early RA: OR 9.023,P = .046) and prednisolone usage (early RA: OR 2.526,P < .001) are positively associated with Clinical Disease Assessment Index (CDAI) decreasing at 3 months. Low baseline DAS28 (REM/LDA: early RA: OR 0.650,P < .001; established RA: OR 0.612,P < .001. REM: early RA: OR 0.743,P = .021; established RA: OR 0.674,P < .001), young age (REM: early RA: OR 0.977,P = .048) and decrease of CDAI at 3 months (REM/LDA: early RA: OR 7.185,P < .001; established RA: OR 8.752,P < .001. REM: early RA: OR 5.602,P < .001; established RA: OR 4.955,P < .001) predict REM/LDA at 6 months. Conclusion Disease activity decreased during follow-ups. Disease duration, baseline disease activity, age, treatment strategies, and CDAI decreasing were associated with treatment response.