ArticleClinical rheumatology2026
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.
Article in Clinical rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesDespite 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.
methodsThis 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.
resultsOver 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.
conclusionsHigher 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.
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