Orthopaedic & Rheumatologic Institute Outcomes

The 2015 American College of Rheumatology (ACR) Guidelines for the Treatment of Rheumatoid Arthritis recommends a treat-to-target strategy with the target being low disease activity using an established disease activity measure¹. We assessed disease activity using RAPID3, a validated patient-reported composite measure of disease activity. Patients with newly diagnosed rheumatoid arthritis started on biologic agents, including anti-tumor necrosis factor inhibitors, IL-6 receptor inhibitors, anti-CD20 antibody, and T-cell costimulatory inhibitor between 2018 and 2022 were reviewed. We considered success as a RAPID3 score of <2.3 (near remission and low severity). 646 rheumatoid arthritis patients were started on a biologic agent during 2018-2022. Of these 48.8% achieved a RAPID3 score of <2.3. The percent of patients in remission or near remission declined from a high of 51.9% in 2019 to 40.4% in 2022. Fewer patients completed RAPID3 assessments in 2022, a result of COVID-19 protocols designed to reduce the risk of transmission, thus these results may not be reflective of the entire population. A significant number of patients remained in moderate or high activity based on RAPID3 scores, indicating the need to monitor and apply treat-to-target strategies in rheumatoid arthritis.

¹Singh JA, Saag KG, Bridges SL Jr, Akl EA, Bannuru RR, Sullivan MC, Vaysbrot E, McNaughton C, Osani M, Shmerling RH, Curtis JR, Furst DE, Parks D, Kavanaugh A, O'Dell J, King C, Leong A, Matteson EL, Schousboe JT, Drevlow B, Ginsberg S, Grober J, St Clair EW, Tindall E, Miller AS, McAlindon T. 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. 2016 Jan;68(1):1-25.