Literature DB >> 29900932

Are We Able to Suppress Disease Activity Adequately in Patients With Established Rheumatoid Arthritis? An Observational and Cross-Sectional Study.

İlker Şengül1, Seniz Akçay Yalbuzdağ1, Buğra Ince1, Altınay Göksel Karatepe1, Taciser Kaya1.   

Abstract

OBJECTIVES: This study aims to explore current disease activity status and simultaneous pharmacological therapies in patients with established rheumatoid arthritis (RA) to determine the extent to which treatment targets are achieved. PATIENTS AND METHODS: One hundred patients (7 males, 93 females; median age 57 years; range 31 to 76 years) with established RA receiving any conventional synthetic disease modifying anti-rheumatic drug (DMARD) and/or biological DMARD for at least three months were enrolled. Disease activity was determined by using the Simplified Disease Activity Index. First, patients were categorized into four groups as remission, low disease activity, moderate disease activity, and high disease activity. Then, they were divided into two subgroups, namely a remission/low disease activity subgroup and moderate disease activity/high disease activity subgroup.
RESULTS: Fifty-one percent of the patients had remission or low disease activity. The most frequently used conventional synthetic DMARDs were methotrexate (50%) and leflunomide (34%). Forty-five percent of patients were receiving glucocorticoid therapy. In patients receiving only conventional synthetic DMARDs, the proportion of remission and low disease activity was 54% (42/78). Forty-two percent (8/19) of the patients receiving biological DMARDs were in remission or had low disease activity. A comparison of subgroups revealed that median age and sulfasalazine use were significantly higher in the moderate disease activity/high disease activity subgroup.
CONCLUSION: The results of this study demonstrated that half of patients with established RA had moderate or high disease activity in our local outpatient clinic. Some barriers might be responsible for the difficulties in controlling disease activity. Determining such barriers might result in a better clinical response during the management of patients with established RA in real-life practice.

Entities:  

Keywords:  Disease activity; disease modifying anti-rheumatic drug; established rheumatoid arthritis

Year:  2015        PMID: 29900932      PMCID: PMC5827827          DOI: 10.5606/ArchRheumatol.2016.5704

Source DB:  PubMed          Journal:  Arch Rheumatol        ISSN: 2148-5046            Impact factor:   1.472


  16 in total

1.  How much does Disease Activity Score in 28 joints ESR and CRP calculations underestimate disease activity compared with the Simplified Disease Activity Index?

Authors:  Roy Fleischmann; Désirée van der Heijde; Andrew S Koenig; Ronald Pedersen; Annette Szumski; Lisa Marshall; Eustratios Bananis
Journal:  Ann Rheum Dis       Date:  2014-08-20       Impact factor: 19.103

2.  A simplified disease activity index for rheumatoid arthritis for use in clinical practice.

Authors:  J S Smolen; F C Breedveld; M H Schiff; J R Kalden; P Emery; G Eberl; P L van Riel; P Tugwell
Journal:  Rheumatology (Oxford)       Date:  2003-02       Impact factor: 7.580

Review 3.  EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs.

Authors:  Josef S Smolen; Robert Landewé; Ferdinand C Breedveld; Maxime Dougados; Paul Emery; Cecile Gaujoux-Viala; Simone Gorter; Rachel Knevel; Jackie Nam; Monika Schoels; Daniel Aletaha; Maya Buch; Laure Gossec; Tom Huizinga; Johannes W J W Bijlsma; Gerd Burmester; Bernard Combe; Maurizio Cutolo; Cem Gabay; Juan Gomez-Reino; Marios Kouloumas; Tore K Kvien; Emilio Martin-Mola; Iain McInnes; Karel Pavelka; Piet van Riel; Marieke Scholte; David L Scott; Tuulikki Sokka; Guido Valesini; Ronald van Vollenhoven; Kevin L Winthrop; John Wong; Angela Zink; Désirée van der Heijde
Journal:  Ann Rheum Dis       Date:  2010-05-05       Impact factor: 19.103

4.  Sonographic joint assessment in rheumatoid arthritis: associations with clinical joint assessment during a state of remission.

Authors:  Miriam Gärtner; Peter Mandl; Helga Radner; Gabriela Supp; Klaus P Machold; Daniel Aletaha; Josef S Smolen
Journal:  Arthritis Rheum       Date:  2013-08

5.  A multi-center, observational study shows high proportion of Australian rheumatoid arthritis patients have inadequate disease control.

Authors:  Geoffrey Littlejohn; Lynden Roberts; Mark Arnold; Paul Bird; Simon Burnet; Julien de Jager; Hedley Griffiths; Dave Nicholls; James Scott; Jane Zochling; Kathleen E Tymms
Journal:  Int J Rheum Dis       Date:  2013-10       Impact factor: 2.454

6.  Assessing remission in clinical practice.

Authors:  M Mierau; M Schoels; G Gonda; J Fuchs; D Aletaha; J S Smolen
Journal:  Rheumatology (Oxford)       Date:  2007-03-06       Impact factor: 7.580

7.  Direct comparison of treatment responses, remission rates, and drug adherence in patients with rheumatoid arthritis treated with adalimumab, etanercept, or infliximab: results from eight years of surveillance of clinical practice in the nationwide Danish DANBIO registry.

Authors:  Merete Lund Hetland; Ib Jarle Christensen; Ulrik Tarp; Lene Dreyer; Annette Hansen; Ib Tønder Hansen; Gina Kollerup; Louise Linde; Hanne M Lindegaard; Uta Engling Poulsen; Annette Schlemmer; Dorte Vendelbo Jensen; Signe Jensen; Gisela Hostenkamp; Mikkel Østergaard
Journal:  Arthritis Rheum       Date:  2010-01

8.  American College of Rheumatology/European League Against Rheumatism provisional definition of remission in rheumatoid arthritis for clinical trials.

Authors:  David T Felson; Josef S Smolen; George Wells; Bin Zhang; Lilian H D van Tuyl; Julia Funovits; Daniel Aletaha; Cornelia F Allaart; Joan Bathon; Stefano Bombardieri; Peter Brooks; Andrew Brown; Marco Matucci-Cerinic; Hyon Choi; Bernard Combe; Maarten de Wit; Maxime Dougados; Paul Emery; Daniel Furst; Juan Gomez-Reino; Gillian Hawker; Edward Keystone; Dinesh Khanna; John Kirwan; Tore K Kvien; Robert Landewé; Joachim Listing; Kaleb Michaud; Emilio Martin-Mola; Pamela Montie; Theodore Pincus; Pamela Richards; Jeffrey N Siegel; Lee S Simon; Tuulikki Sokka; Vibeke Strand; Peter Tugwell; Alan Tyndall; Desirée van der Heijde; Suzan Verstappen; Barbara White; Frederick Wolfe; Angela Zink; Maarten Boers
Journal:  Arthritis Rheum       Date:  2011-03

9.  Clinical and functional remission: even though biologics are superior to conventional DMARDs overall success rates remain low--results from RABBIT, the German biologics register.

Authors:  Joachim Listing; Anja Strangfeld; Rolf Rau; Jörn Kekow; Erika Gromnica-Ihle; Thilo Klopsch; Winfried Demary; Gerd-Rüdiger Burmester; Angela Zink
Journal:  Arthritis Res Ther       Date:  2006-04-05       Impact factor: 5.156

Review 10.  Optimal dosage and route of administration of methotrexate in rheumatoid arthritis: a systematic review of the literature.

Authors:  K Visser; D van der Heijde
Journal:  Ann Rheum Dis       Date:  2008-11-25       Impact factor: 19.103

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