Baseline CDAI within low disease activity predicts differing rheumatoid arthritis outcomes

An observational study in Arthritis Care & Research examined whether baseline Clinical Disease Activity Index (CDAI) scores within remission or low disease activity predicted subsequent outcomes in rheumatoid arthritis. Investigators used baseline and prospective follow-up data from the CorEvitas registry for 6,856 patients exposed to biologic or JAK disease-modifying antirheumatic drugs. Patients had baseline CDAI scores of 0–10 and validated patient-reported outcome measurements.

Among patients with baseline CDAI scores of 2.8–6, 19.5% exceeded a CDAI of 10 at one year and 19.6% at two years. Corresponding proportions for patients with baseline scores >6–10 were 31.2% and 31.0%. The abstract reported p<0.001 for change in CDAI from baseline in the low disease activity subgroups. In crude and adjusted models, patients in the higher baseline subgroup were almost twice as likely to have moderate disease activity at both follow-up points.

The findings suggest that the CDAI low disease activity category encompasses patients with different prognoses, potentially informing treatment-target discussions. However, this observational association does not establish that treatment intensification improves outcomes in the higher subgroup. Only the abstract was available; adjustment variables, follow-up completeness, detailed patient-reported outcomes, and confidence intervals were not provided.