Selected patient characteristics at restart of b/tsDMARD compared with b/tsDMARD stop in patients who stopped due to remission or other reasons
| Patient characteristics | Remission n=208 | Remission n=100 | P value | Other reasons n=438 | Other reasons n=325 | P value |
| Index date | Outcome date | Index date | Outcome date | |||
| Mean age (years) (SD) | 57.8 (15.2) | 57.8 (15.7) | 1.00 | 56.1 (15.1) | 55.5 (14.8) | 0.59 |
| Women (%) | 146 (70.2) | 75 (75.0) | 0.38 | 349 (79.7) | 262 (80.6) | 0.75 |
| Men (%) | 62 (29.8) | 25 (25.0) | 89 (20.3) | 63 (19.4) | ||
| Smoker (%) | 51 (24.5) | 25 (25.0) | 0.04 | 97 (22.2) | 65 (20) | 0.08 |
| Non-smoker (%) | 136 (65.4) | 73 (73.0) | 231 (52.7) | 197 (60.6) | ||
| Missing smoking (%) | 21 (10.1) | 2 (2.0) | 110 (25.1) | 63 (19.4) | ||
| Median RA duration (IQR) | 5.1 (3.1–10.5) | 6.1 (3.8–11.7) | 0.14 | 7.4 (3.3–16.4) | 8.1 (3.5–17) | 0.13 |
| Missing RA duration (%) | 5 (2.4) | 2 (2.0) | 11 (2.5) | 7 (0.2) | ||
| University hospital (%) | 38 (18.3) | 20 (20) | 0.84 | 75 (17.1) | 69 (21.2) | 0.37 |
| Other hospital (%) | 28 (13.5) | 15 (15) | 57 (13) | 41 (12.6) | ||
| Office (%) | 142 (68.3) | 65 (65) | 303 (69.2) | 214 (65.9) | ||
| Missing setting* (%) | 0 (0) | 0 (0) | 3 (0.7) | 1 (0.3) | ||
| Family history of rheum. dis.† (%) | 42 (20.2) | 24 (24.0) | 0.15 | 116 (26.5) | 89 (27.4) | 0.54 |
| No family history of rheum. dis.† (%) | 125 (60.1) | 65 (65.0) | 214 (48.9) | 167 (51.4) | ||
| Missing family history (%) | 41 (19.7) | 11 (11.0) | 108 (24.7) | 69 (21.2) | ||
| Rheumatoid factor positive (%) | 140 (67.3) | 72 (72) | 0.57 | 304 (69.4) | 235 (72.3) | 0.66 |
| Rheumatoid factor negative (%) | 60 (28.9) | 26 (26) | 116 (26.5) | 79 (24.3) | ||
| Missing information (%) | 8 (3.9) | 2 (2) | 18 (4.1) | 11 (3.4) | ||
| ACPA positive (%) | 120 (57.7) | 67 (67) | 0.25 | 256 (58.5) | 209 (64.3) | 0.26 |
| ACPA negative (%) | 65 (31.3) | 26 (26) | 107 (24.4) | 68 (20.9) | ||
| Missing information (%) | 23 (11.1) | 7 (7) | 75 (17.1) | 48 (14.8) | ||
| Mean DAS28-ESR (SD) | 2.0 (0.6) | 3.5 (1.6) | <0.0001 | 3.1 (1.2) | 3.9 (1.4) | <0.01 |
| Missing DAS28-ESR (%) | 135 (64.9) | 53 (53.0) | 331 (75.6) | 185 (56.9) | ||
| Mean RADAI score (SD) | 1.4 (1.3) | 3.5 (1.9) | <0.0001 | 3.0 (2.1) | 3.5 (2.2) | 0.09 |
| Missing RADAI score (%) | 150 (72.1) | 72 (72.0) | 344 (78.5) | 234 (72.2) | ||
| Median HAQ score (IQR) | 0.1 (0–0.6) | 0.5 (0.1–1.0) | 0.02 | 0.8 (0.3–1.3) | 0.9 (0.3–1.5) | 0.36 |
| Missing HAQ score (%) | 143 (68.8) | 64 (64.0) | 328 (74.9) | 221 (68.2) | ||
| Median EuroQoL score (IQR) | 77.9 (71.3–100) | 69 (63.6–77.9) | <0.001 | 69 (59.8–77.9) | 68.7 (57.0–77.9) | 0.04 |
| Missing EuroQoL score (%) | 149 (71.6) | 64 (64.0) | 359 (82.0) | 241 (74.4) | ||
| Mean SF-12 PC score (SD) | 48.6 (7.8) | 41.8 (9.9) | <0.01 | 40.3 (10.3) | 37.5 (10.2) | 0.08 |
| Mean SF-12 MC score (SD) | 51.5 (9.1) | 48.6 (9.2) | 0.20 | 47.5 (10.6) | 45.6 (11.4) | 0.25 |
| Missing SF-12 PC/MC score (%) | 156 (75) | 76 (76.0) | 352 (80.4) | 242 (74.7) | ||
| csDMARD use‡ (%) | 73 (35.1) | 32 (32.0) | 0.59 | 178 (40.6) | 115 (35.4) | 0.14 |
| Prednisone use§ (%) | 30 (14.4) | 19 (19.0) | 0.30 | 132 (30.1) | 100 (30.8) | 0.85 |
| Other anti-inflammatory med.¶ (%) | 72 (34.6) | 45 (45.0) | 0.08 | 182 (41.6) | 150 (46.2) | 0.20 |
| Cardiac disorders (%) | 11 (5.3) | 7 (7.0) | 0.55 | 35 (8) | 28 (8.6) | 0.76 |
| Metabolic syndrome** (%) | 13 (6.3) | 11 (11.0) | 0.15 | 24 (5.5) | 29 (8.9) | 0.06 |
| Infections†† (%) | 8 (3.9) | 5 (5.0) | 0.63 | 14 (3.2) | 17 (5.2) | 0.16 |
| Osteoarthritis or arthroplasty (%) | 42 (20.2) | 25 (25.0) | 0.34 | 96 (21.9) | 78 (24.0) | 0.50 |
| Cancer (%) | 11 (5.3) | 4 (4.0) | 0.62 | 18 (4.1) | 15 (4.6) | 0.73 |
| Fibromyalgia‡‡ | 14 (6.7) | 8 (8.0) | 0.69 | 43 (9.8) | 41 (12.6) | 0.22 |
| Other auto-immune diseases§§ (%) | 14 (6.7) | 8 (8.0) | 0.69 | 20 (4.6) | 21 (6.5) | 0.25 |
| Depression/anxiety (%) | 16 (7.7) | 8 (8.0) | 0.93 | 51 (11.6) | 36 (11.1) | 0.81 |
All patient characteristics can be found in online supplemental file 5.
*Missing categories were not used to estimate p-values per group
†Family history includes RA, ankylosing spondylitis, psoriasis, psoriatic arthritis, chronic inflammatory bowel disease and other spondyloarthropathies (eg, reactive arthritis).
‡csDMARD use includes methotrexate, leflunomid, sulfasalazin, chloroquine, azathioprine, ciclosporin A, cyclophosphamide.
§Prednisone use includes systemic or intra-articular prednisone use.
¶Use of other pain/anti-inflammatory medications includes cyclo-oxygenase-2 inhibitors, other analgetics, conventional non-steroidal anti-inflammatory drugs, antidepressants, paracetamol, opiates, alternative treatments.
**Metabolic syndrome defined as at least three out of the following four diagnoses: hyperlipidaemia, hypertension, overweight (body mass index ≥30 kg/m2), diabetes type 1 or 2.
††infections were captured in a 3-month lookback window only.
‡‡Fibromyalgia diagnoses include patients who have at least 10 more painful joints than swollen joints.
§§Other auto-immune diseases include Sjogren syndrome, systemic lupus erythematosus and other autoimmune diseases unspecified.
ACPA, anti-citrullinated protein antibodies; b/tsDMARD, biological or targeted synthetic disease-modifying antirheumatic drug; csDMARD, conventional synthetic disease-modifying antirheumatic drug; DAS, disease activity score; rheum. dis., rheumatic diseases; ESR, erythrocyte sedimentation rate; EuroQoL, a standardised instrument for measuring generic health status (EQ-5D); HAQ, Health Assessment Questionnaire; IQR, Interquartile range; MC, mental component; med, medication; PC, physical component; RA, rheumatoid arthritis; RADAI, Rheumatoid Arthritis Disease Activity Index; SD, Standard deviation; SF, short-form (health survey).