scholarly journals Erosions in the foot at baseline are predictive of orthopaedic shoe use after 10 years of treat to target therapy in patients with recent onset rheumatoid arthritis

2015 ◽  
Vol 35 (8) ◽  
pp. 2101-2107 ◽  
Author(s):  
Sytske Anne Bergstra ◽  
Iris M. Markusse ◽  
Gülşah Akdemir ◽  
H. Karel Ronday ◽  
K. Huub Han ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Target Therapy ◽  
Treat To Target ◽  
Recent Onset

THU0259 10 Years of Treat-To-Target Therapy in Rheumatoid Arthritis Patients (The Best Study): Clinical and Radiographic Outcomes:

2014 ◽  
Vol 73 (Suppl 2) ◽  
pp. 272.2-273
Author(s):  
I. Markusse ◽  
L. Dirven ◽  
M. vd Broek ◽  
G. Akdemir ◽  
Y. Goekoop-Ruiterman ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Target Therapy ◽  
Treat To Target ◽  
Radiographic Outcomes

Calprotectin as a marker of inflammation in patients with early rheumatoid arthritis

2017 ◽  
Vol 76 (12) ◽  
pp. 2031-2037 ◽  
Author(s):  
Maria Karolina Jonsson ◽  
Nina Paulshus Sundlisæter ◽  
Hilde Haugedal Nordal ◽  
Hilde Berner Hammer ◽  
Anna-Birgitte Aga ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Treatment Response ◽  
Radiographic Progression ◽  
Activity Index ◽  
Inflammatory Marker ◽  
Target Therapy ◽  
Power Doppler ◽  
Treat To Target ◽  
Symptom Duration

ObjectivesCalprotectin is an inflammatory marker of interest in rheumatoid arthritis (RA). We evaluated whether the level of calprotectin was associated with disease activity, and if it was predictive of treatment response and radiographic progression in patients with early RA.MethodsPlasma from disease-modifying antirheumatic drug (DMARD)-naïve patients with RA fulfilling 2010 American College of Rheumatology/European League Against Rheumatism classification criteria with symptom duration <2 years was analysed for calprotectin at baseline, and after 1, 3 and 12 months. All patients received treat-to-target therapy, as part of a randomised controlled strategy trial (ARCTIC). The association between calprotectin, erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) and measures of disease activity were assessed by correlations. We used likelihood ratios and logistic regression models to assess the predictive value of the baseline inflammatory markers for treatment response and radiographic damage.Results215 patients were included: 61% female, 82% anti-citrullinated peptide antibody positive, mean (SD) age 50.9 (13.7) years and median (25, 75 percentile) symptom duration 5.8 (2.8, 10.5) months. Calprotectin was significantly correlated with Clinical Disease Activity Index (r=0.32), ESR (r=0.50) and ultrasonography power Doppler (r=0.42) before treatment onset. After 12 months of treatment, calprotectin, but not ESR and CRP, was significantly correlated with power Doppler (r=0.27). Baseline levels of calprotectin, ESR and CRP were not predictive of treatment response, but high levels of calprotectin were associated with radiographic progression in multivariate models.ConclusionsCalprotectin was correlated with inflammation assessed by ultrasound before and during DMARD treatment, and was also associated with radiographic progression. The data support that calprotectin may be of interest as an inflammatory marker when assessing disease activity in different stages of RA.Trial registration numberNCT01205854; Post-results.

Early Local Swelling and Tenderness Are Associated with Large-joint Damage After 8 Years of Treatment to Target in Patients with Recent-onset Rheumatoid Arthritis

2013 ◽  
Vol 40 (5) ◽  
pp. 624-629 ◽  
Author(s):  
Marianne van den Broek ◽  
Linda Dirven ◽  
Herman M. Kroon ◽  
Margreet Kloppenburg ◽  
H. Karel Ronday ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Functional Disability ◽  
Linear Regression Analysis ◽  
Health Assessment ◽  
Joint Damage ◽  
Treat To Target ◽  
Local Damage ◽  
Larsen Score ◽  
Recent Onset ◽  
Large Joint

Objective.To assess whether early swelling and tenderness in large joints in patients with rheumatoid arthritis (RA) is predictive of later local damage and whether this leads to functional disability.Methods.Two-year clinical and 8-year radiological followup data from the BeSt study (trial numbers NTR262 and NTR265), a randomized controlled treat-to-target trial, were used. The association between early local joint swelling and/or tenderness (at least once, or for ≥ 2 consecutive visits) and later large-joint damage (Larsen score ≥ 1) was assessed using generalized estimating equations. The association between large-joint damage and functional ability [by Health Assessment Questionnaire (HAQ)] was assessed using logistic and linear regression analysis.Results.Clinical and 8-year radiological data were available for 290 patients. Concomitant local joint swelling and tenderness at least once in the first 2 years was independently associated with damage of the large joints (OR 2.5, 95% CI 1.7–3.6), as was swelling without tenderness (OR 2.0, 95% CI 1.1–3.6). Stronger effects were seen for persistent swelling and/or tenderness. Other independent predictors for joint damage were baseline erythrocyte sedimentation rate (OR 1.01, 95% CI 1.01–1.02) and the presence of rheumatoid factor and/or anticitrullinated protein antibodies (OR 2.5, 95% CI 1.5–4.1; and OR 2.2, 95% CI 1.3–3.8, respectively). Patients with large-joint damage had a higher HAQ score after 8 years than patients without (difference 0.15).Conclusion.Early local swelling and tenderness are independent predictors of later joint damage in these joints after 8 years of Disease Activity Score-guided treatment in patients with RA. This suggests that suppression of local inflammation could help prevent local damage and functional disability.

scholarly journals Evaluating Adherence to a Treat-to-Target Protocol in Recent-Onset Rheumatoid Arthritis: Reasons for Compliance and Hesitation

2016 ◽  
Vol 68 (4) ◽  
pp. 446-453 ◽  
Author(s):  
I. M. Markusse ◽  
L. Dirven ◽  
K. H. Han ◽  
H. K. Ronday ◽  
P. B. J. de Sonnaville ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Treat To Target ◽  
Recent Onset

scholarly journals Fatigue in patients with early rheumatoid arthritis undergoing treat-to-target therapy: predictors and response to treatment

2021 ◽  
pp. annrheumdis-2021-220750
Author(s):  
Karen Holten ◽  
Nina Paulshus Sundlisater ◽  
Siri Lillegraven ◽  
Joseph Sexton ◽  
Lena Bugge Nordberg ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Target Therapy ◽  
Randomised Trial ◽  
Power Doppler ◽  
Disease Onset ◽  
Treat To Target ◽  
Symptom Duration ◽  
Tight Control ◽  
Early Ra

ObjectivesFatigue is a frequent symptom in rheumatoid arthritis (RA) and has high impact on quality of life. We explored associations between disease activity and fatigue in patients with early RA during the initial 24 months of modern treat-to-target therapy and predictors of fatigue after 24 months of follow-up.MethodsData were obtained from the treat-to-target, tight control Aiming for Remission in Rheumatoid Arthritis: a Randomised Trial Examining the Benefit of Ultrasound in a Clinical Tight Control Regime (ARCTIC) trial. Fatigue was measured on a visual analogue scale (VAS) from 0 to 100 mm and defined as clinically relevant if VAS was ≥20 mm. Baseline predictors of fatigue at 24 months were analysed by multivariable logistic regression.Results205 patients with fatigue data at baseline and 24 months were included. Median (25th, 75th percentiles) symptom duration was 5.4 months (2.8, 10.4), fatigue VAS 37.0 mm (13.0, 62.0) and mean Disease Activity Score (DAS) 3.4 (SD 1.1) at baseline. Prevalence of fatigue declined from 69% at baseline to 38% at 24 months. Fewer swollen joints (OR 0.92, 95% CI 0.87 to 0.98, p=0.006), lower power Doppler ultrasound score (OR 0.95, 95% CI 0.90 to 0.99, p=0.027) and higher patient global assessment (PGA) (OR 1.03, 95% CI 1.01 to 1.04, p<0.001) increased the risk of clinically relevant fatigue at 24 months. Not achieving remission at 6 months was associated with a higher risk of reporting fatigue at 24 months.ConclusionsFatigue in patients with early RA was prevalent at disease onset, with a rapid and sustained reduction during treatment. Low objective disease activity and high PGA at baseline were predictors of clinically relevant fatigue at 24 months.

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