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Long term follow up of an early oligoarthritis cohort shows that early aggressive intervention leads to drug free remission after 10 years: results from the LOTO study

Concepcion Castillo-Gallego, Michael J Green, Sibel Z Aydin, Sharmin Nizam, Paul Emery & Helena Marzo-Ortega

Objective: To report the long-term outcome in the long-term follow up of the Leeds Early Oligoarthritis Cohort. Methods: Cross-sectional follow up of patients who participated in two previous interventional studies. Subjects were invited to either attend for a single study visit or a telephone consults. Presence/absence of any musculoskeletal symptoms and current diagnosis was recorded. Blood tests for inflammatory markers and radiographs of SIJs or any relevant joints were performed only if clinically indicated to establish a diagnosis if persistent clinical symptoms. Results: Follow up data were available from 63.3% (n=74 patients) of the initial cohort (n=117 patients) [mean SD disease duration at presentation 11.8 ± 1.8 months; disease duration at follow up: 13 ± 3 years]. Of these 74 patients, 63.51% (n=47) had persistent arthritis since the end of the previous studies (19.5% were RF positive; 33.3% anti-CCP positive and 32.4% HLA-B27 positive). The majority (75%) had received joint steroid injections sulfasalazine on the original study protocols. Oligoarthritis was still the predominant articular pattern in 68% of the patients at follow up and over a third of patients (36.5%) were in clinical remission (4% and 17.4% RF and HLA-B27 positive respectively). Conclusion: Ten-year follow up of an early oligoarthritis cohort shows that over a third of patients attending for review are in drug free clinical remission.