{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T01:07:04Z","timestamp":1788311224728,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T00:00:00Z","timestamp":1737072000000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The continuous update of international guidelines and enhanced availability of biological disease\u2010modifying antirheumatic drugs (bDMARDs) and targeted synthetic DMARDs (tsDMARDs) have made a significant impact on the diagnosis and treatment of early rheumatoid arthritis (ERA). This study aims to systematically evaluate the current treatment strategies and outcomes within a large\u2010scale cohort of patients with ERA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from the Chinese Registry of Rheumatoid Arthritis (CREDIT), a large multicenter Chinese registry of RA, were collected to analyze temporal trends in clinical profiles, therapeutic strategies, and treatment outcomes among patients with ERA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From November 2016 to October 2023, A total of 2722 patients with follow\u2010up information for 6\u2009months were included. The use of methotrexate (MTX) increased annually and has become the predominant DMARD as the initial treatment. Following initial therapy, 1059 (38.9%) patients achieved the therapeutic target of low disease activity and remission. Age\u2009\u2265\u200950\u2009years (adjusted OR 0.70 [95% CI 0.59\u20130.83];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), high baseline disease activity (adjusted OR 0.48 [95% CI 0.41\u20130.57];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), csDMARD monotherapy other than MTX (adjusted OR 0.55 [95% CI 0.41\u20130.73];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and the use of b\/tsDMARDs without a csDMARD combination (adjusted OR 0.57 [95% CI 0.36\u20130.87];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011) were associated with lower target attainment rates. For patients who did not achieve the treatment target after initial therapy, the use of b\/tsDMARDs increased after 2020, although the extent of therapeutic escalation remained suboptimal.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Treatment of patients with ERA in China has become more standardized. Adherence to guideline\u2010directed therapeutic regimens has emerged as a significant determinant of therapeutic target achievement. The increased prevalence of b\/tsDMARDs would benefit more patients in ameliorating the disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1756-185x.70066","type":"journal-article","created":{"date-parts":[[2025,1,18]],"date-time":"2025-01-18T01:50:57Z","timestamp":1737165057000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Chinese Registry of Rheumatoid Arthritis (CREDIT) VI: Temporal Trends in Patients With Early Rheumatoid Arthritis and Moderate\u2010To\u2010Severe Disease Activity \u2010 A Multicenter Cohort Study of Treatment Strategies and Outcomes"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7321-8698","authenticated-orcid":false,"given":"Yafang","family":"Deng","sequence":"first","affiliation":[{"name":"School of Medicine, Tsinghua Medicine Tsinghua University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Qiao","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences and Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC\u2010DID), Ministry of Science and Technology; State Key Laboratory of Complex Severe and Rare Diseases; Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongbin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Rheumatology The Affiliated Hospital of Inner Mongolia Medical College  Hohhot Inner Mongolia China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4993-451X","authenticated-orcid":false,"given":"Chen","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences and Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC\u2010DID), Ministry of Science and Technology; State Key Laboratory of Complex Severe and Rare Diseases; Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shangyi","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences and Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC\u2010DID), Ministry of Science and Technology; State Key Laboratory of Complex Severe and Rare Diseases; Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology The First People's Hospital of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology  Kunming Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinghua","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology First Affiliated Hospital (Southwest Hospital) of Army Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijun","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology People's Hospital of Xinjiang Uygur Autonomous Region  Urumqi Xinjiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinwang","family":"duan","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology The Second Affiliated Hospital of Nanchang University  Nanchang Jiangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1612-561X","authenticated-orcid":false,"given":"Jian","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology First Affiliated Hospital of Kunming Medical University  Kunming Yunnan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5482-5014","authenticated-orcid":false,"given":"Hanyou","family":"Mo","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology The First Affiliated Hospital of Guangxi Medical University  Nanning Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenyu","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology The First Hospital of Jilin University  Changchun Jilin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5287-8593","authenticated-orcid":false,"given":"Nan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences and Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC\u2010DID), Ministry of Science and Technology; State Key Laboratory of Complex Severe and Rare Diseases; Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Bio\u2010Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofeng","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences and Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC\u2010DID), Ministry of Science and Technology; State Key Laboratory of Complex Severe and Rare Diseases; Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education  Beijing China"},{"name":"State Key Laboratory of Common Mechanism Research for Major Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengtao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences and Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC\u2010DID), Ministry of Science and Technology; State Key Laboratory of Complex Severe and Rare Diseases; Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education  Beijing China"},{"name":"State Key Laboratory of Common Mechanism Research for Major Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1687-519X","authenticated-orcid":false,"given":"Qian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences and Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC\u2010DID), Ministry of Science and Technology; State Key Laboratory of Complex Severe and Rare Diseases; Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education  Beijing China"},{"name":"State Key Laboratory of Common Mechanism Research for Major Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1511-7952","authenticated-orcid":false,"given":"Xinping","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences and Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC\u2010DID), Ministry of Science and Technology; State Key Laboratory of Complex Severe and Rare Diseases; Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"CREDIT Co\u2010authors","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,17]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2103726"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.13103"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-210602"},{"issue":"5","key":"e_1_2_11_5_1","first-page":"667","article-title":"Classification Criteria of Early Rheumatoid Arthritis and Validation of Its Performance in a Multi\u2010Centre Cohort","volume":"32","author":"Zhao J.","year":"2014","journal-title":"Clinical and Experimental Rheumatology"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kez151"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2022-223356"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.41752"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.2478\/rir-2021-0002"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2022-223365"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000002110"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-017-1457-z"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000001517"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.13996"},{"issue":"5","key":"e_1_2_11_15_1","first-page":"836","article-title":"Chinese Registry of Rheumatoid Arthritis (CREDIT): I. 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