NATURAL REMISSION IN INFLAMMATORY POLYARTHRITIS - ISSUES OF DEFINITION AND PREDICTION

This paper reports the frequency and predictors of remission (no arthr itis on examination and no treatment with second-line drugs or steroid s within the previous 3 months) in 355 patients with early inflammator y polyarthritis (IP) referred to the Norfolk Arthritis Register. Two y ears after referral, 91 patients (25%) were in remission, 32 of whom h ad also been in remission at 1 yr. Remission rates were twice as high in patients with undifferentiated inflammatory polyarthritis at baseli ne as in those who satisfied criteria for rheumatoid arthritis. To ide ntify predictors of remission, a logistic regression model was develop ed on a random two-thirds of the patients and validated on the remaini ng one-third. Remission at 2 yr was associated with male gender and fe wer than six tender joints at baseline. However, even the best-fitting model was not sensitive enough to be useful clinically. Thus, amongst patients with early IP in the community, remission rates at 2 yr are low. Further, it was impossible, using simple clinical measures, to pr edict those patients whose arthritis would resolve.