Influencing Factors And Patient-reported Outcomes Of Treat-to-target For Rheumatoid Arthritis

Objective:To explore whether there were differences between early RA patients and long course RA patients in disease activity and treatment compliance rate;To explore the quality of life of patients with early RA and long course RA and the factors influencing the standard treatment,so as to provide theoretical basis for early diagnosis,early treatment,control of disease progression and improvement of prognosis.Methods:In this prospective study,a total of 172 patients with rheumatoid arthritis were enrolled.According to the course of disease,they were divided into ERA patients(group A,course ≤2 years)and long course RA patients(group B,course>2 years).The differences of disease activity in RA patients were analyzed.The clinical characteristics,disease activity index,disease activity degree,quality of life and treatment plan of the patients who reached the treatment target and those who did not were further analyzed according to whether the treatment reached the target or not,and the factors influencing the treatment reached the target were analyzed.Results:1.According to DAS28,CDAI and SDAI disease activity scores,patients with ERA at different follow-up stages had lower disease activity than patients with RA with long course(P<0.05).The disease activity level decreased faster,the clinical remission time was shorter,and the treatment compliance rate was higher.The rate of clinical remission at 12 months of follow-up was lower than in 6 months.2.There were differences in albumin,disease activity index and disease activity degree between patients who reached the treatment standard and those who did not(P<0.05).There were differences in disease activity index and degree of disease activity in patients with standard treatment before and after treatment(P<0.05).3.There were differences in joint function,PF,MH and EQ5D-VAS in quality of life between the early RA standard group and the non-standard group(P<0.05);MH and SAS were different between the RA standard group and the non-standard group(P<0.05).Although there was no statistical difference in other scale items,the follow-up curve showed that the quality of life(joint function,health status,work status,etc.)of the standard group was higher than that of the non-standard group,while anxiety,depression and productivity loss were lower than that of the non-standard group.4.The use of NSAIDs decreased in group A and B;In group A,the proportion of csDMARDs was increased,and the proportion of tsDMARDs or bDMARDs was decreased.In group B,the proportion of csDMARDs in the standard group,A group and B group that did not reach the standard decreased,and the proportion of combined tsDMARDs or bDMARDs increased.5.RF,ESR,TJC,SJC,PGA,PhGA and anxiety were the risk factors affecting the rate of rheumatoid arthritis treatment(P<0.05).csDMARDS combined with tsDMARDs or bDMARDs was a protective factor affecting the compliance rate of long-term rheumatoid arthritis treatment(P=0.019).Conclusion:1.In RA patients,the disease activity decreased in June,and the rate of meeting the treatment criteria increased.In early RA patients,the disease activity decreased more obviously,and it was easier to achieve the treatment goals.However,the rate of clinical remission decreased during follow-up at 12 months,which affected the rate of meeting the treatment standards.Early standardized treatment should be used to help patients maintain long-term clinical remission.2.The disease activity degree of the treatment standard group was lower than that of the non-standard group,and the quality of life of the treatment standard group was higher than that of the non-standard group.The disease activities had different degrees of negative impact on the psychology of patients,so early psychological intervention should be carried out to improve the quality of life of patients.3.Inflammation index,disease activity index and SAS were positively correlated with the disease activity of early rheumatoid arthritis.Disease activity index and anxiety are the risk factors affecting the rate of early rheumatoid arthritis treatment.4.The use of csDMARDs in early RA can effectively control disease activities,reduce the probability of combined drug use,and help to reduce the economic burden caused by disease treatment.When disease control is poor,csDMARDs combined with tsDMARDs or bDMARDs can help reduce disease activity in RA patients and improve treatment compliance rates.5.The use of csDMARDs in early RA can effectively control disease activities,reduce the probability of combined drug use,and help to reduce the economic burden caused by disease treatment.When disease control is poor,csDMARDs combined with tsDMARDs or bDMARDs can help reduce disease activity in RA patients and improve treatment compliance rates.