OBJECTIVE: To compare the outcome of early rheumatoid arthritis (RA) patients in a country where early clinics were established versus the outcome of patients in nonprotocolized clinics. METHODS: We compared 2 multicenter cohorts: an RA cohort derived from an early arthritis registry set in 36 reference hospitals in which a specific intervention was established (Evaluation of a Model for Arthritis Care in Spain [SERAP]), and a historical control cohort of patients with early RA attending 34 rheumatology departments (Prognosis in Rheumatoid Arthritis [PROAR] cohort). Effectiveness was tested by comparing the change in the Disease Activity Score in 28 joints (DAS28), the change in the Health Assessment Questionnaire (HAQ), and the change in the Sharp/van der Heijde radiologic score using marginal structural models. RESULTS: A total of 161 early RA patients were recruited in the PROAR cohort and 447 in the SERAP cohort. Being a SERAP patient was inversely correlated with activity, resulting in a decrease of -0.24 (95% confidence interval [95% CI] -0.39, -0.08) units in the population average of the DAS28 after adjustment was made. Moreover, intervention may be seen as a protective factor of radiologic damage, with a decrease of -0.05 (95% CI -0.09, -0.01) units in the logarithm of the total Sharp/van der Heijde score. On the other hand, a decrease in functional impairment was detected, but intervention was not statistically associated with HAQ changes. CONCLUSION: Preventing major radiographic progression in a 2-year term inside structured and organized special programs for the management of disease, such as early arthritis clinics, are effective compared to nonprotocolized referrals, treatment, and followup.
OBJECTIVE: To compare the outcome of early rheumatoid arthritis (RA) patients in a country where early clinics were established versus the outcome of patients in nonprotocolized clinics. METHODS: We compared 2 multicenter cohorts: an RA cohort derived from an early arthritis registry set in 36 reference hospitals in which a specific intervention was established (Evaluation of a Model for Arthritis Care in Spain [SERAP]), and a historical control cohort of patients with early RA attending 34 rheumatology departments (Prognosis in Rheumatoid Arthritis [PROAR] cohort). Effectiveness was tested by comparing the change in the Disease Activity Score in 28 joints (DAS28), the change in the Health Assessment Questionnaire (HAQ), and the change in the Sharp/van der Heijde radiologic score using marginal structural models. RESULTS: A total of 161 early RApatients were recruited in the PROAR cohort and 447 in the SERAP cohort. Being a SERAP patient was inversely correlated with activity, resulting in a decrease of -0.24 (95% confidence interval [95% CI] -0.39, -0.08) units in the population average of the DAS28 after adjustment was made. Moreover, intervention may be seen as a protective factor of radiologic damage, with a decrease of -0.05 (95% CI -0.09, -0.01) units in the logarithm of the total Sharp/van der Heijde score. On the other hand, a decrease in functional impairment was detected, but intervention was not statistically associated with HAQ changes. CONCLUSION: Preventing major radiographic progression in a 2-year term inside structured and organized special programs for the management of disease, such as early arthritis clinics, are effective compared to nonprotocolized referrals, treatment, and followup.
Authors: Estíbaliz Loza; Cristina Lajas; Jose Luis Andreu; Alejandro Balsa; Isidoro González-Álvaro; Oscar Illera; Juan Ángel Jover; Isabel Mateo; Javier Orte; Javier Rivera; José Manuel Rodríguez Heredia; Fredeswinda Romero; Juan Antonio Martínez-López; Ana María Ortiz; Esther Toledano; Virginia Villaverde; Loreto Carmona; Santos Castañeda Journal: Rheumatol Int Date: 2014-12-28 Impact factor: 2.631
Authors: José Andrés Román Ivorra; Juan Antonio Martínez; Pablo Lázaro; Federico Navarro; Antonio Fernandez-Nebro; Eugenio de Miguel; Estibaliz Loza; Loreto Carmona Journal: Rheumatol Int Date: 2013-04-09 Impact factor: 2.631
Authors: Isidoro González-Álvaro; Carmen Martínez-Fernández; Benito Dorantes-Calderón; Rosario García-Vicuña; Blanca Hernández-Cruz; Alicia Herrero-Ambrosio; Olatz Ibarra-Barrueta; Emilio Martín-Mola; Emilio Monte-Boquet; Alberto Morell-Baladrón; Raimon Sanmartí; Jesús Sanz-Sanz; Francisco Javier de Toro-Santos; Paloma Vela; José Andrés Román Ivorra; José Luis Poveda-Andrés; Santiago Muñoz-Fernández Journal: Rheumatology (Oxford) Date: 2014-12-19 Impact factor: 7.580