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Objectives <p>Despite treat-to-target strategies improving rheumatoid arthritis (RA) outcomes, the factors that sustain long-term functional remission remain unclear. This study examined predictors associated with maintaining functional remission, specifically those preventing deterioration of the Health Assessment Questionnaire-Disability Index (HAQ-DI) in patients with RA who had achieved HAQ-DI remission.</p> Methods <p>This retrospective cohort study included patients with RA who were followed continuously for 10&#xa0;years from 2015 and who achieved baseline HAQ-DI remission. Annual HAQ-DI and disease activity scores were recorded. New comorbidities were evaluated using the Rheumatic Disease Comorbidity Index. Patients were classified as stable (ΔHAQ-DI ≤ 0: HAQS) or deteriorated (ΔHAQ-DI ≥ 0.125: HAQW). Baseline and longitudinal factors associated with functional decline were analyzed using univariate and multivariate logistic regression models.</p> Results <p>Over 10&#xa0;years, the mean Simplified Disease Activity Index (SDAI) remained low; however, HAQ-DI worsened in 26% of patients. The HAQS group (<i>n</i> = 59) had a lower 10-year average SDAI (SDAIA: 2.51 vs 4.09, <i>p</i> &lt; 0.01). Fracture was the most frequent new comorbidity (<i>n</i> = 13). In the multivariate analysis, higher SDAIA (odds ratio (OR) 1.33, 95% confidence interval (CI) 1.06–1.68) and fracture (OR 4.93, 95% CI 1.13–21.4) were identified as independent risk factors for functional decline.</p> Conclusions <p>Higher mean SDAI and new fractures independently predicted long-term functional decline in RA. Sustaining low disease activity alone is insufficient; achieving and maintaining clinical remission is essential for preserving HAQ-DI over a 10-year period.</p>

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Maintaining clinical remission and preventing fractures are essential for preserving functional status over a 10-year period in patients with rheumatoid arthritis who have achieved Health Assessment Questionnaire-Disability Index remission: a retrospective cohort study

  • 期刊论文

  • 发表日期：

    2026年2月21日

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  • Kensuke Koyama,
  • Tetsuro Ohba,
  • Ryousuke Koizumi,
  • Koki Watabe,
  • Hirotaka Haro

摘要

Objectives

Despite treat-to-target strategies improving rheumatoid arthritis (RA) outcomes, the factors that sustain long-term functional remission remain unclear. This study examined predictors associated with maintaining functional remission, specifically those preventing deterioration of the Health Assessment Questionnaire-Disability Index (HAQ-DI) in patients with RA who had achieved HAQ-DI remission.

Methods

This retrospective cohort study included patients with RA who were followed continuously for 10 years from 2015 and who achieved baseline HAQ-DI remission. Annual HAQ-DI and disease activity scores were recorded. New comorbidities were evaluated using the Rheumatic Disease Comorbidity Index. Patients were classified as stable (ΔHAQ-DI ≤ 0: HAQS) or deteriorated (ΔHAQ-DI ≥ 0.125: HAQW). Baseline and longitudinal factors associated with functional decline were analyzed using univariate and multivariate logistic regression models.

Results

Over 10 years, the mean Simplified Disease Activity Index (SDAI) remained low; however, HAQ-DI worsened in 26% of patients. The HAQS group (n = 59) had a lower 10-year average SDAI (SDAIA: 2.51 vs 4.09, p < 0.01). Fracture was the most frequent new comorbidity (n = 13). In the multivariate analysis, higher SDAIA (odds ratio (OR) 1.33, 95% confidence interval (CI) 1.06–1.68) and fracture (OR 4.93, 95% CI 1.13–21.4) were identified as independent risk factors for functional decline.

Conclusions

Higher mean SDAI and new fractures independently predicted long-term functional decline in RA. Sustaining low disease activity alone is insufficient; achieving and maintaining clinical remission is essential for preserving HAQ-DI over a 10-year period.