Characteristics and prevalence of clinical remission of rheumatoid arthritis in a nationwide study from Indonesia

Bagus Putu Putra Suryana, Rudy Hidayat, Sumariyono Sarmidi, Suryo Anggoro Kusumo Wibowo, Laniyati Hamijoyo, Andri Reza Rahmadi, Blondina Marpaung, Andi Raga Ginting, Gede Kambayana, Pande Ketut Kurniari, Mahriani Sylvawani, Najirman, Nyoman Suarjana, Deddy Nur Wachid Achadiono, Lita Diah Rahmawati, Awalia, Bantar Suntoko, Ika Vemilia Warlisti, Arief Nurudhin, Nurhasan Agung PrabowoRadiyati Umi Partan, Muhammad Reagan, Endy Adnan, Jeffrey Arthur Ongkowijaya, Natsir Akil, Mirza Zaka Pratama

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Aim: To investigate the clinical characteristics, DMARD treatment pattern, remission rate, and factors associated with disease remission of rheumatoid arthritis (RA) patients in Indonesia. Method: A multicenter survey was conducted in 2019–2020 involving 16 hospitals in Indonesia. Inclusion criteria were RA patients who fulfilled the 2010 ACR/EULAR classification criteria, were aged ≥18 years, and have been treated with 1 DMARD or more for at least 6 months, with exclusion criteria being the co-existence of other autoimmune diseases or pain syndromes. Disease activities and remission rate were defined using DAS28-ESR. Results: A total of 870 patients were completed for analysis. Remission was achieved in 24.5% of patients, while low disease activity in 18.5%, moderate disease activity in 44.6%, and high disease activity in 12.4%. The distribution of conventional DMARDs from subjects was methotrexate 69.9%, leflunomide 15.9%, sulfasalazine 12.0%, chloroquine/hydroxychloroquine 8.9%, and cyclosporine 4.8%. Patients treated with biologic DMARDs were only 0.3%. The mean methotrexate dose was 11.2 ± 4.0 mg/week, and the mean methotrexate duration was 45.1 ± 36.6 months. The majority of patients received glucocorticoids (65.5%). 71.1% received DMARD monotherapy, while 28.9% had combined DMARDs. According to the multivariate analysis, delayed time to diagnosis and treatment (>6 months), DMARD monotherapy, and glucocorticoid use were negatively associated with disease remission. Conclusion: The remission rate of Indonesian RA patients is 24.5%, and low disease activity is 18.5%. Methotrexate and leflunomide are the most frequent conventional DMARDs used. Delayed diagnosis, delayed treatment, and DMARD monotherapy contributed to the current low remission rate in Indonesia.

Original languageEnglish
Article numbere15050
JournalInternational Journal of Rheumatic Diseases
Issue number2
Publication statusPublished - Feb 2024


  • Indonesia
  • remission rate
  • rheumatoid arthritis


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