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In 2000, a specific biologic outpatient clinic and prospective database was created to enable close monitoring of these novel therapies. This clinic is described in detail in a prior study in this journal [37]. This current study compares outcomes on commencing therapy, at 1 year and most recent review.

Baseline, 1-year (1.04 ± 0.15 years) and 12-year (11.76 ± 2.69 years) assessments were compared. Demographics (age, gender, educational level, employment), smoking status, diagnosis, disease duration, medications, Health Assessment Questionnaire (HAQ), patient global health (PGH), tender joint count (TJC), swollen joint count (SJC), C-reactive protein (CRP), rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA) status and erosive status on X-rays of the hands and feet were reviewed. Erosive status was defined by the presence or absence of erosions on standard plain X-rays of the hands and feet as reported by a consultant musculoskeletal radiologist. The 28-joint count Disease Activity Score with CRP (DAS28-CRP) was calculated, as it is a validated measure in both RA and PsA clinical trials, and remission was classified as DAS28-CRP < 2.6 according to the European League Against Rheumatism (EULAR) criteria [38, 39]. Disease activity was defined as low (DAS28-CRP ≤ 3.2), moderate (3.2 < DAS28-CRP ≤ 5.1) or high (DAS28-CRP > 5.1) [38, 40, 41]. Patients who did not commence a named biologic at the clinic review were excluded from the study (n = 64).

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