OBJECTIVE: To explore the impact of an early treatment response on maintenance of work capacity in patients with early, active rheumatoid arthritis (RA). METHODS: In the Finnish Rheumatoid Arthritis Combination Therapy trial, 195 patients with recent-onset RA were randomized to receive either a combination of disease-modifying antirheumatic drugs (DMARDs) with prednisolone or a single DMARD with or without prednisolone for 2 years. Treatment responses were evaluated according to the American College of Rheumatology (ACR) criteria. After a 5-year followup, the cumulative number of days of sick leave and RA-related permanent work disability was calculated for each of the 162 patients who were available for the active work force at baseline. RESULTS: Of the 159 patients assessed at 6 months, 29 were in clinical remission, 66 achieved an ACR50 response but not remission, 29 achieved an ACR20 response but not an ACR50 response, and 35 failed to achieve an ACR20 response. In these 4 groups, the median numbers of work disability days per patient-year from 6 months through 60 months of followup were 0 (interquartile range [IQR] 0-3), 4 (IQR 0-131), 16 (IQR 0-170), and 352 (16-365), respectively (P < 0.001). Pairwise multiple comparisons showed a statistically significant difference between all groups except the ACR50 and ACR20 groups. At 12 months, 30 patients were in remission. None of the 44 patients in remission at 6 or 12 months became permanently work disabled over the 5-year followup, as compared with 15 patients in the ACR50 group (23%), 6 in the ACR20 group (21%), and 19 without an ACR20 response at 6 months (56%). CONCLUSION: Prompt induction of remission translates into maintenance of work capacity. At 6 months, an ACR50 response is no better than an ACR20 response with regard to future productivity, while failure to achieve an ACR20 response carries a high risk for work disability.
RCT Entities:
OBJECTIVE: To explore the impact of an early treatment response on maintenance of work capacity in patients with early, active rheumatoid arthritis (RA). METHODS: In the Finnish Rheumatoid Arthritis Combination Therapy trial, 195 patients with recent-onset RA were randomized to receive either a combination of disease-modifying antirheumatic drugs (DMARDs) with prednisolone or a single DMARD with or without prednisolone for 2 years. Treatment responses were evaluated according to the American College of Rheumatology (ACR) criteria. After a 5-year followup, the cumulative number of days of sick leave and RA-related permanent work disability was calculated for each of the 162 patients who were available for the active work force at baseline. RESULTS: Of the 159 patients assessed at 6 months, 29 were in clinical remission, 66 achieved an ACR50 response but not remission, 29 achieved an ACR20 response but not an ACR50 response, and 35 failed to achieve an ACR20 response. In these 4 groups, the median numbers of work disability days per patient-year from 6 months through 60 months of followup were 0 (interquartile range [IQR] 0-3), 4 (IQR 0-131), 16 (IQR 0-170), and 352 (16-365), respectively (P < 0.001). Pairwise multiple comparisons showed a statistically significant difference between all groups except the ACR50 and ACR20 groups. At 12 months, 30 patients were in remission. None of the 44 patients in remission at 6 or 12 months became permanently work disabled over the 5-year followup, as compared with 15 patients in the ACR50 group (23%), 6 in the ACR20 group (21%), and 19 without an ACR20 response at 6 months (56%). CONCLUSION: Prompt induction of remission translates into maintenance of work capacity. At 6 months, an ACR50 response is no better than an ACR20 response with regard to future productivity, while failure to achieve an ACR20 response carries a high risk for work disability.
Authors: M Das; J Lu; M Joseph; R Aggarwal; S Kanji; B K McMichael; B S Lee; S Agarwal; A Ray-Chaudhury; O H Iwenofu; P Kuppusamy; V J Pompili; M K Jain; H Das Journal: Curr Mol Med Date: 2012-02 Impact factor: 2.222
Authors: K Puolakka; H Kautiainen; M Pekurinen; T Möttönen; P Hannonen; M Korpela; M Hakala; M Arkela-Kautiainen; R Luukkainen; M Leirisalo-Repo Journal: Ann Rheum Dis Date: 2005-11-16 Impact factor: 19.103
Authors: Tuulikki Sokka; Hannu Kautiainen; Theodore Pincus; Suzanne M M Verstappen; Amita Aggarwal; Rieke Alten; Daina Andersone; Humeira Badsha; Eva Baecklund; Miguel Belmonte; Jürgen Craig-Müller; Licia Maria Henrique da Mota; Alexander Dimic; Nihal A Fathi; Gianfranco Ferraccioli; Wataru Fukuda; Pál Géher; Feride Gogus; Najia Hajjaj-Hassouni; Hisham Hamoud; Glenn Haugeberg; Dan Henrohn; Kim Horslev-Petersen; Ruxandra Ionescu; Dmitry Karateew; Reet Kuuse; Ieda Maria Magalhaes Laurindo; Juris Lazovskis; Reijo Luukkainen; Ayman Mofti; Eithne Murphy; Ayako Nakajima; Omondi Oyoo; Sapan C Pandya; Christof Pohl; Denisa Predeteanu; Mjellma Rexhepi; Sylejman Rexhepi; Banwari Sharma; Eisuke Shono; Jean Sibilia; Stanislaw Sierakowski; Fotini N Skopouli; Sigita Stropuviene; Sergio Toloza; Ivo Valter; Anthony Woolf; Hisashi Yamanaka Journal: Arthritis Res Ther Date: 2010-03-12 Impact factor: 5.156
Authors: Kimme L Hyrich; Chris Deighton; Kath D Watson; Deborah P M Symmons; Mark Lunt Journal: Rheumatology (Oxford) Date: 2009-08-25 Impact factor: 7.580