An increasing number of Australian patients with RA are reaching remission, five-year data from OPAL shows.

The latest figures from the OPAL-QUMI database which included 37,274 individual DAS28-erythrocyte sedimentation rate scores for 8998 patients showed the frequency of remission increased from 36.7% in 2009 to 53.5% in 2014.

This coincided with an increase in the use of biologic DMARDs and prednisolone for patients in remission – increasing from 17% to 36.9% and 27.6%  to 36.8% respectively, over the same time period, reported Geoff Littlejohn and colleagues in the Journal of Rheumatology. 

“This may suggest patients with more severe RA are now being managed more aggressively than previously because of the availability of newer medications and careful clinical appraisal of patients who meet government reimbursement criteria for these drugs,” they wrote.

In parallel the number of patients with high disease activity, moderate disease activity and low disease activity also decreased, results showed.

Reason for the improvements in disease activity scores were likely to be a result of an increased focus on a treat-to-target strategy, easy access to DAS28 measures, and an increase in the number of rheumatologists contributing to the database, the study authors suggested.

An increased awareness among rheumatologists about the high percentage of patients with moderate disease activity in the cohort may have also contributed to improvements.

Improved disease activity is likely to have a significant effect on the outcome of patients, with a reduction in long term comorbidities, less joint damage, and less disability over time, the study group concluded.

“This clearly also has significant economic implications that are also the subject of further exploration by the group,” they added.