Sustained Remission in Patients with Rheumatoid Arthritis on
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A study was performed to compare the real-world efficacy of biological therapy (biologic diseasemodifying antirheumatic drug+MTX) versus triple therapy (Methotrexate (MTX)+Sulfasalazine+Hydroxychloroquine/Chloroquine) in rheumatoid arthritis (RA) patients in terms of sustained remission (SR).

RA patients who recieved biological/triple therapy as first treatment strategy after MTX monotherapy were included. SR was defined as DAS28 less than 2.6 for more than 6 months (“short?term?SR”) and more than 24 months (“long?term?SR”). Comparisons were performed during treatment at 1 and 2 years in:
1) All patients starting therapy and
2) Patients remaining on therapy using propensity score(PS) adjusted regression analyses and additionally
3) At any time during follow?up irrespective of therapy retention using survival analyses.

--1502 patients were included (1155/347 receiving biological/triple therapy).

--For patients starting therapy, adjusted odds ratios (biological/triple) for short?term and long?term?SR at 1 year were 1.79 and 1.86; at 2 years 1.92 and 1.62.

--For patients remaining on therapy, corresponding results at 1 year were 1.12 and 1.31; at 2 years 0.85 and 0.76.

--Hazard ratios for short?term and long?term?SR at any time during follow?up were 1.15 and 1.09.

In conclusion, biological therapy was more successful for patients beginning biological/triple therapy in terms of keeping on therapy and achieving SR. However, regardless of therapy retention, equal probabilities for achieving SR were found among patients who remained on therapy and at any time during follow-up. While biological therapy has a higher chance of achieving SR, triple therapy could be an alternative to biological therapy for certain RA patients without jeopardizing potential chances of achieving SR.