Introduction: The European League Against Rheumatism updates the recommendations for managing rheumatoid arthritis. Again, it is not specified which DAS28 is there in view (with erythrocyte sedimentation rate or C-reactive protein). Aim: The aim of the study is to check whether Disease Activity Score-28 (erythrocyte sedimentation rate) and Disease Activity Score-28 (C-reactive protein) represent equally the activity of rheumatoid arthritis in the course of treatment with biological agents. Materials and methods: In a retrospective study we analyzed the database of real clinical practice over a 12-month period of biological treatment of rheumatoid arthritis. Disease Activity Score-28 (erythrocyte sedimentation rate) and (C-reactive protein) are compared at the start and at the end of the study. Results: The mean difference between the two variants of disease activity scores at baseline and at the end of the study is significant (p < 0.001). The Disease Activity Score-28 (erythrocyte sedimentation rate) represents a remarkably small proportion of patients with remission and low activity (<3.2) at baseline (18.46%) and at the end of the study (40.51%). Disease Activity Score-28 (C-reactive protein) represents a significantly high proportion of patients in remission and low activity (<3.2) at the end of the study (69.74%). Estimates of activity according to the two variants show significant discrepancy between each other and low level of agreement (kappa = 0.235-0.464). Discrepancies are not related to the type of biological drug (anti-TNF or not). Conclusion: The two DAS28 variants are not interchangeable with the same threshold for low activity in measuring the response to biological therapy.

Objectives: The present study aimed to evaluate the long-term survival of patients with rheumatoid arthritis (RA) receiving biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in a real-world setting, and to identify key prognostic factors influencing mortality within this cohort. Methods: This retrospective, observational cohort study analyzed 165 patients with confirmed RA who were on b/tsDMARD treatment for at least six months as of June 2017. Patient data, including demographics, disease duration, prior therapeutic regimens, and global functional status were extracted from medical records to collect data covering a seven-year follow-up period, extending from June 2017 to December 2024. Corticosteroid use was defined as continuous systemic intake during the RA activity analysis period. Survival outcomes were analyzed using Kaplan-Meier methods and multivariate Cox proportional hazards models to identify independent predictors of mortality. Results: Over a mean follow-up of 9.4 years, the mortality rate was 13.5 deaths per 1000 treatment-years, with an overall survival rate of 87.3%. Advanced functional disability and prolonged corticosteroid use were independently associated with higher mortality risk. In subgroup analyses, chronic kidney disease significantly increased mortality among patients on TNF inhibitors. In contrast, patients who remained on their initial anti-IL6 therapy had lower mortality, though this may reflect survivor bias. Conclusions: This study highlights the importance of long-term b/tsDMARD intervention in RA patients, with observed low mortality and high survival rates. Subgroup findings suggest the importance of comorbidity management in TNFi users and therapeutic stability in anti-IL6 users.

The aim of the study is to establish the frequency and sustained remission and low disease activity in patients with RA in the course of long-term treatment with synthetic and biological means (DMARDs) in real conditions. In the conditions of retrospective data analysis of real clinical practice, there were included 209 patients suffering from RA. Activity indexes of RA in all patients were analyzed in the last year of treatment with bDMARDs. The average age of the patients is 59,01 years old. The dominants sex is female (84.6%). The beginning of treatment with biological therapy is delayed with the average of 8.21 year. In all activity indexes of RA, which were monitored in the beginning of the 6th and the 12th months, there was established a significant difference in their variation for the periods surveyed. There is a general trend towards lowering the values of our indicators. In the beginning of the monitored period, the patients going into remission (DAS28 CRP) are approximately 3 times less – 11% (n = 23) in comparison with those in the end of the study – 32.99% (n = 64) (p < 0.001). In 10% of the cases a sustained remission is observed by both combined indexes (DAS28 ESR and DAS28 CRP) (p < 0.001). Today the accurate way is the “treat to target” strategy. The purpose is lowering the activity of the disease to very low levels (or remission) and achieving a long-term remission which is now real and achievable.