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Multicenter Study
. 2025 Apr;44(4):1505-1511.
doi: 10.1007/s10067-025-07370-7. Epub 2025 Feb 25.

Differences in rates of remission between rheumatoid factor positive and negative rheumatoid arthritis patients: experience from a resource-limited setting

Abel Tenaw Tasamma  1 , Bethesaida Zerihun Eshetu  2 , Alazar Tesfamariam Seyoum  3 , Senay Admasu Woldegiorgis  4 , Melatework Assefa Wolle  3 , Getachew Wuhib Shumye  5 , Tsegabrhan Gebrewahid Weldegiorgis  6 , Aron Berhanu Gudetta  3 , Berhanu Moges Abera  7
Affiliations
Multicenter Study

Differences in rates of remission between rheumatoid factor positive and negative rheumatoid arthritis patients: experience from a resource-limited setting

Abel Tenaw Tasamma et al. Clin Rheumatol. 2025 Apr.

Abstract

Background: Rheumatoid arthritis (RA) is an autoimmune disease of the joints with occasional involvement of extra-articular organs. Although rheumatoid factor (RF) is associated with more severe baseline disease severity and a higher incidence of extraarticular diseases, whether it predicts response to treatment in patients taking conventional disease-modifying antirheumatic drugs (DMARDs) is unclear as evidence has so far been conflicting.

Methods: A 3-year (January 2021 to December 2023) multicenter retrospective cohort study was done at 1 public and 4 private hospitals in Addis Ababa, Ethiopia. After categorizing eligible patients into RF-positive and RF-negative, they were retrospectively followed for 12 months. A disease activity score in 28 joints (DAS-28) score of less than 2.6 was used to define remission. The time-to-remission between the two groups was compared using the Kaplan-Meier survival function. In order to control for potential confounders, the Cox regression model was used to calculate adjusted hazard ratios (AHR).

Results: After screening a total of 676 patients, 207 were found to be eligible for the study. The median (interquartile range (IQR)) age at diagnosis was 46 (36 - 58) years, and 171 (82.6%) were female. At 12 months of follow-up, remission occurred in 39.4% of RF-positive patients and 60.0% of RF-negative patients (AHR, 0.57; 95% confidence interval (CI), (0.368-0.88; P = 0.012). The overall remission rate was 47.3%.

Conclusion: In this study, among patients taking conventional DMARDs, RF-negative RA patients achieved better remission rates compared to RF-positive patients. The study provides insight into the association between RF status and treatment outcome among RA patients in a resource-limited setting. Key Points • Our work adds to the existing body of knowledge regarding the relationship between RF positivity and response to treatment in patients with RA. It is also the first study to examine this association in a previously understudied population of Sub-Saharan Africa.

Keywords: Remission; Rheumatoid arthritis; Rheumatoid factor.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The ethical clearance of the study was obtained, and informed consent was waived by the Institutional Review Board (IRB) of Addis Ababa University, College of Health Sciences. All the information obtained was confidential and used only for the intended purpose. Consent for publication: Not applicable. Disclosures: None.

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