OBJECTIVE: To investigate earlier prediction of future articular destruction in patients with early rheumatoid arthritis (RA). METHODS: We randomly allocated patients with RA with disease duration < 2 years to different nonbiologic disease modifyingantirheumatic drug (DMARD) therapies in a double-blind trial. Progression of articular destruction over the 96-week treatment period was assessed using the modified Sharp method. RESULTS:Progression of articular destruction correlated more strongly with the American College of Rheumatology (ACR) core set measures after 12 weeks of treatment than with pretreatment values. Multiple regression analysis of data after 12 weeks yielded a correlation coefficient of 0.711. The sensitivity and specificity to predict articular destruction over the 75th percentile of the cohort were 78.6% and 84.6%, respectively. Patients who showed articular destruction over the 75th percentile of the cohort had low response to treatment at 12 weeks, and continued to have high clinical disease activity thereafter. Contrasting data were found in patients with slow progression of articular destruction. CONCLUSION: In patients with early RA, ACR core set measures after 12 weeks of nonbiologic DMARD treatment may predict articular destruction 2 years later. Low response to treatment at 12 weeks and continuing high disease activity thereafter were found in patients with rapid radiological progression. These data can be used to determine the appropriateness of treatment at 12 weeks and aid the decision to introduce biologic DMARD.
RCT Entities:
OBJECTIVE: To investigate earlier prediction of future articular destruction in patients with early rheumatoid arthritis (RA). METHODS: We randomly allocated patients with RA with disease duration < 2 years to different nonbiologic disease modifying antirheumatic drug (DMARD) therapies in a double-blind trial. Progression of articular destruction over the 96-week treatment period was assessed using the modified Sharp method. RESULTS: Progression of articular destruction correlated more strongly with the American College of Rheumatology (ACR) core set measures after 12 weeks of treatment than with pretreatment values. Multiple regression analysis of data after 12 weeks yielded a correlation coefficient of 0.711. The sensitivity and specificity to predict articular destruction over the 75th percentile of the cohort were 78.6% and 84.6%, respectively. Patients who showed articular destruction over the 75th percentile of the cohort had low response to treatment at 12 weeks, and continued to have high clinical disease activity thereafter. Contrasting data were found in patients with slow progression of articular destruction. CONCLUSION: In patients with early RA, ACR core set measures after 12 weeks of nonbiologic DMARD treatment may predict articular destruction 2 years later. Low response to treatment at 12 weeks and continuing high disease activity thereafter were found in patients with rapid radiological progression. These data can be used to determine the appropriateness of treatment at 12 weeks and aid the decision to introduce biologic DMARD.
Authors: K Krüger; J Wollenhaupt; K Albrecht; R Alten; M Backhaus; C Baerwald; W Bolten; J Braun; H Burkhardt; G Burmester; M Gaubitz; A Gause; E Gromnica-Ihle; H Kellner; J Kuipers; A Krause; H-M Lorenz; B Manger; H Nüßlein; H-G Pott; A Rubbert-Roth; M Schneider; C Specker; H Schulze-Koops; H-P Tony; S Wassenberg; U Müller-Ladner Journal: Z Rheumatol Date: 2012-09 Impact factor: 1.372
Authors: Rocio V Gamboa-Cárdenas; Manuel F Ugarte-Gil; Massardo Loreto; Mónica P Sacnun; Verónica Saurit; Mario H Cardiel; Enrique R Soriano; Cecilia Pisoni; Claudio M Galarza-Maldonado; Carlos Rios; Sebastião C Radominski; Geraldo da R Castelar-Pinheiro; Washington Alves Bianchi; Simone Appenzeller; Inés Guimarães da Silveira; Cristiano A de Freitas Zerbini; Carlo V Caballero-Uribe; Adriana Rojas-Villarraga; Marlene Guibert-Toledano; Francisco Ballesteros; Rubén Montufar; Janitzia Vázquez-Mellado; Jorge Esquivel-Valerio; Ignacio García De La Torre; Leonor A Barile-Fabris; Fedra Irazoque Palezuelos; Lilia Andrade-Ortega; Pablo Monge; Raquel Teijeiro; Ángel F Achurra-Castillo; María H Esteva Spinetti; Graciela S Alarcón; Bernardo A Pons-Estel Journal: Clin Rheumatol Date: 2019-06-03 Impact factor: 2.980
Authors: Katinka Albrecht; Klaus Krüger; Jürgen Wollenhaupt; Rieke Alten; Marina Backhaus; Christoph Baerwald; Wolfgang Bolten; Jürgen Braun; Harald Burkhardt; Gerd R Burmester; Markus Gaubitz; Angela Gause; Erika Gromnica-Ihle; Herbert Kellner; Jens Kuipers; Andreas Krause; Hans-Martin Lorenz; Bernhard Manger; Hubert Nüßlein; Hans-Georg Pott; Andrea Rubbert-Roth; Matthias Schneider; Christof Specker; Hendrik Schulze-Koops; Hans-Peter Tony; Siegfried Wassenberg; Ulf Müller-Ladner Journal: Rheumatol Int Date: 2013-08-14 Impact factor: 2.631
Authors: Xavier M Teitsma; Jenny Devenport; Johannes W G Jacobs; Attila Pethö-Schramm; Michelle E A Borm; Petra Budde; Johannes W J Bijlsma; Floris P J G Lafeber Journal: PLoS One Date: 2020-12-10 Impact factor: 3.240