[Long-term drug therapy of rheumatoid arthritis and remission].

Aim: To evaluate the duration of rheumatoid arthritis (RA) remission with respect to different drug treatments.
Materials and Methods: Remission duration observed at 20-year follow-up of 442 RA patients living in the south of Estonia has been reviewed. Also, the data are provided on the disease onset, articular status, systemic lesions, RA activity and progression, the latest exacerbation and previous remission, standard laboratory indices, humoral immunity, examination of the biopsy of the articular tissues and subcutaneous fat for amyloid.
Results: According to the retrospective analysis, slow-progressive RA course occurs primarily in remissions longer than 5 years and less frequently in remissions lasting from 1 to 5 years. No matter what the drug was used, 14% of the patients have failed the treatment. 3% of the patients were in remission longer than 5 years. Short-term remissions (1-3 months) were induced in 13%, stable ones (3 months-1 year) in 39% of the cases. These remissions were observed in early RA, more frequently in patients with initial arthritis of the small joints. Remissions from 1 to 5 years were registered in 31% of the patients.
Conclusion: RA remissions up to 1 year represent temporary clinical improvement and do not inhibit progression of the rheumatoid process. Consideration of association between RA clinical course and remission duration helps to recognize groups of RA risk and to timely change treatment policy.