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Peer-reviewedCC BY-NC 4.0RMD Open

Transformative improvement with staggered gains in rheumatoid arthritis remission and sustained remission, but higher relapse rates: a population-based cohort study from 1990 to 2019

  • Georges El Hasbani1
  • Roslin Jose George1
  • Sara J Achenbach2
  • John M Davis1
  • Cynthia S Crowson1,2
  • Elena Myasoedova1,2
  1. 1Division of Rheumatology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
  2. 2Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
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Abstract

Objectives To report population-level data describing long-term trends in remission, sustained remission and relapse among patients with rheumatoid arthritis (RA).Methods We conducted a population-based inception cohort study of adults with incident RA in Olmsted County, Minnesota, USA, meeting 1987 or 2010 ACR criteria between 1990 and 2019. Patients were followed through 31 December 2023. We estimated cumulative incidence of first remission, sustained remission (≥6 months) and relapse after remission, accounting for competing risk of death. Cox models comparing calendar periods were adjusted for age, sex, baseline body mass index and serostatus.Results Among 1179 patients followed for a median of 9.4 years, 816 achieved remission and 630 achieved sustained remission. One-year remission, defined by our prespecified criteria, increased from 12.8% in 1990–1999 to 26.4% in 2010–2019. Median time to remission shortened from 6.4 years to 2.8 years. Despite these gains, relapse within 5 years after remission increased from 62.8% in 1990–1999 vs 79.2% in the 2010–2023 period.Conclusion Remission in RA has become earlier and more frequent over time, but durability has not improved. Strategies to sustain remission remain a critical unmet need.

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Cite

BibTeXRIS
BibTeX
@article{hasbani2026transformative,
  title = {{Transformative improvement with staggered gains in rheumatoid arthritis remission and sustained remission, but higher relapse rates: a population-based cohort study from 1990 to 2019}},
  author = {Georges El Hasbani and Roslin Jose George and Sara J Achenbach and John M Davis and Cynthia S Crowson and Elena Myasoedova},
  journal = {RMD Open},
  year = {2026},
  month = oct,
  doi = {10.1136/rmdopen-2026-007297},
  url = {https://doi.org/10.1136/rmdopen-2026-007297},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Transformative improvement with staggered gains in rheumatoid arthritis remission and sustained remission, but higher relapse rates: a population-based cohort study from 1990 to 2019
AU  - Georges El Hasbani
AU  - Roslin Jose George
AU  - Sara J Achenbach
AU  - John M Davis
AU  - Cynthia S Crowson
AU  - Elena Myasoedova
PY  - 2026
DA  - 2026/10/23
JO  - RMD Open
DO  - 10.1136/rmdopen-2026-007297
UR  - https://doi.org/10.1136/rmdopen-2026-007297
AB  - Objectives To report population-level data describing long-term trends in remission, sustained remission and relapse among patients with rheumatoid arthritis (RA).Methods We conducted a population-based inception cohort study of adults with incident RA in Olmsted County, Minnesota, USA, meeting 1987 or 2010 ACR criteria between 1990 and 2019. Patients were followed through 31 December 2023. We estimated cumulative incidence of first remission, sustained remission (≥6 months) and relapse after remission, accounting for competing risk of death. Cox models comparing calendar periods were adjusted for age, sex, baseline body mass index and serostatus.Results Among 1179 patients followed for a median of 9.4 years, 816 achieved remission and 630 achieved sustained remission. One-year remission, defined by our prespecified criteria, increased from 12.8% in 1990–1999 to 26.4% in 2010–2019. Median time to remission shortened from 6.4 years to 2.8 years. Despite these gains, relapse within 5 years after remission increased from 62.8% in 1990–1999 vs 79.2% in the 2010–2023 period.Conclusion Remission in RA has become earlier and more frequent over time, but durability has not improved. Strategies to sustain remission remain a critical unmet need.
SN  - 2056-5933
ER  -