scholarly journals Costs and disease activity in early rheumatoid arthritis in 1996–2000 and 2006–2011, improved outcome and shift in distribution of costs: a two-year follow-up

2018 ◽  
Vol 47 (5) ◽  
pp. 378-383 ◽  
Author(s):  
M Husberg ◽  
L Bernfort ◽  
E Hallert
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Early Rheumatoid Arthritis ◽  
Improved Outcome

scholarly journals POS0647 EFFICACY, SAFETY AND CHARACTERISTICS OF IGURATIMOD-BASED THERAPY IN THE TREATMENT OF UA, ERA AND RA PATIENTS FOR 24 WEEKS: A PROSPECTIVE COHORT STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 561.2-562
Author(s):  
X. Liu ◽  
Z. Sun ◽  
W. Guo ◽  
F. Wang ◽  
L. Song ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
Adverse Events ◽  
Disease Activity ◽  
Prospective Cohort Study ◽  
Early Rheumatoid Arthritis ◽  
Prospective Cohort ◽  
Combined Treatment ◽  
Serious Adverse Events

Background:Experts emphasize early diagnosis and treatment in RA, but the widely used diagnostic criterias fail to meet the accurate judgment of early rheumatoid arthritis. In 2012, Professor Zhanguo Li took the lead in establishing ERA “Chinese standard”, and its sensitivity and accuracy have been recognized by peers. However, the optimal first-line treatment of patients (pts) with undifferentiated arthritis (UA), early rheumatoid arthritis (ERA), and rheumatoid arthritis (RA) are yet to be established.Objectives:To evaluate the efficacy and safety of Iguratimod-based (IGU-based) Strategy in the above three types of pts, and to explore the characteristics of the effects of IGU monotherapy and combined treatment.Methods:This prospective cohort study (ClinicalTrials.gov Identifier NCT01548001) was conducted in China. In this phase 4 study pts with RA (ACR 1987 criteria[1]), ERA (not match ACR 1987 criteria[1] but match ACR/EULAR 2010 criteria[2] or 2014 ERA criteria[3]), UA (not match classification criteria for ERA and RA but imaging suggests synovitis) were recruited. We applied different treatments according to the patient’s disease activity at baseline, including IGU monotherapy and combination therapies with methotrexate, hydroxychloroquine, and prednisone. Specifically, pts with LDA and fewer poor prognostic factors were entered the IGU monotherapy group (25 mg bid), and pts with high disease activity were assigned to combination groups. A Chi-square test was applied for comparison. The primary outcomes were the proportion of pts in remission (REM)or low disease activity (LDA) that is DAS28-ESR<2.6 or 3.2 at 24 weeks, as well as the proportion of pts, achieved ACR20, Boolean remission, and good or moderate EULAR response (G+M).Results:A total of 313 pts (26 pts with UA, 59 pts with ERA, and 228 pts with RA) were included in this study. Of these, 227/313 (72.5%) pts completed the 24-week follow-up. The results showed that 115/227 (50.7%), 174/227 (76.7%), 77/227 (33.9%), 179/227 (78.9%) pts achieved DAS28-ESR defined REM and LDA, ACR20, Boolean remission, G+M response, respectively. All parameters continued to decrease in all pts after treatment (Fig 1).Compared with baseline, the three highest decline indexes of disease activity at week 24 were SW28, CDAI, and T28, with an average decline rate of 73.8%, 61.4%, 58.7%, respectively. Results were similar in three cohorts.We performed a stratified analysis of which IGU treatment should be used in different cohorts. The study found that the proportion of pts with UA and ERA who used IGU monotherapy were significantly higher than those in the RA cohort. While the proportion of triple and quadruple combined use of IGU in RA pts was significantly higher than that of ERA and UA at baseline and whole-course (Fig 2).A total of 81/313 (25.8%) pts in this study had adverse events (AE) with no serious adverse events. The main adverse events were infection(25/313, 7.99%), gastrointestinal disorders(13/313, 4.15%), liver dysfunction(12/313, 3.83%) which were lower than 259/2666 (9.71%) in the previous Japanese phase IV study[4].The most common reasons of lost follow-up were: 1) discontinued after remission 25/86 (29.1%); 2) lost 22/86 (25.6%); 3) drug ineffective 19/86 (22.1%).Conclusion:Both IGU-based monotherapy and combined therapies are tolerant and effective for treating UA, ERA, and RA, while the decline in joint symptoms was most significant. Overall, IGU combination treatments were most used in RA pts, while monotherapy was predominant in ERA and UA pts.References:[1]Levin RW, et al. Scand J Rheumatol 1996, 25(5):277-281.[2]Kay J, et al. Rheumatology 2012, 51(Suppl 6):vi5-9.[3]Zhao J, et al. Clin Exp Rheumatol 2014, 32(5):667-673.[4]Mimori T, et al. Mod Rheumatol 2019, 29(2):314-323.Disclosure of Interests:None declared

scholarly journals Predictive factors related to the progression of periodontal disease in patients with early rheumatoid arthritis: a cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ana María Heredia-P ◽  
Gloria Inés Lafaurie ◽  
Wilson Bautista-Molano ◽  
Tamy Goretty Trujillo ◽  
Philippe Chalem-Choueka ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Periodontal Disease ◽  
Disease Activity ◽  
Early Rheumatoid Arthritis ◽  
Predictive Factors ◽  
Related Protein ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Generalised Linear Mixed Model

Abstract Background Rheumatoid arthritis (RA) and periodontal disease are inter-related conditions. However, factors predictive of periodontal disease progression in patients with early rheumatoid arthritis (eRA) are lacking. The aim of this study was to identify factors associated with the progression of clinical attachment loss (CAL) in interproximal dental sites of eRA patients. Methods Twenty-eight eRA patients were evaluated for the progression of CAL at 280 interproximal dental sites at 1 year of follow-up. Markers of RA activity (rheumatoid factor, erythrocyte sedimentation rate, and C-reactive protein), a marker of bone resorption (Dickkopf-related protein 1), Disease Activity Score 28 and Simple Disease Activity Index were included as potential systemic predictive factors. Plaque index, gingival index, pocket depth, clinical attachment level and Dickkopf-related protein 1 in crevicular fluid at baseline were included as potential local predictive factors. Data were analysed in a hierarchical structure using generalised linear mixed models for progression at each site (> 2 mm) during follow-up. Results C-reactive protein level was the most important predictive systemic factor for the progression of CAL. The mean CAL and a high degree of gingival inflammation in interproximal sites at baseline were important predictive local factors (p <  0.0001). Patients who received combined treatment with disease-modifying antirheumatic drugs and corticosteroids exhibited less CAL (p <  0.0001). The predictive value of the generalised linear mixed model for progression was 85%. Conclusions Systemic factors, including RA disease activity and baseline periodontal condition, were associated with periodontal progression. Pharmacological treatment may affect periodontal progression in patients with early RA.

AB0194 VITAMIN D TRAJECTORIES IN EARLY DIAGNOSED, AGGRESSIVELY TREATED RHEUMATOID ARTHRITIS PATIENTS: A 10 YEAR LONGITUDINAL COHORT STUDY BASED ON THE DANISH CIMESTRA TRIAL

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1397-1397
Author(s):  
M. Herly ◽  
K. Stengaard-Pedersen ◽  
P. Vestergaard ◽  
R. Christensen ◽  
S. Möller ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Vitamin D ◽  
Disease Activity ◽  
Early Rheumatoid Arthritis ◽  
Vitamin D Supplementation ◽  
Reference List ◽  
Disease Course ◽  
Research Support ◽  
Vitamin D Levels

Background:Low vitamin D levels are common in Rheumatoid Arthritis (RA)1, and possibly associated with disease course,2but data on vitamin D levels during long-term disease course has not been reported previously.Objectives:To describe vitamin D trajectories from time of diagnosis through 10 years follow-up in early diagnosed RA patients.Methods:The CIMESTRA trial included 160 newly diagnosed RA-patients, treated aiming at remission with methotrexate and intraarticular steroid, further randomized to ciclosporine or placebo. Vitamin D supplementation was recommended according to national guidelines. Vitamin Dtotalwas measured at diagnosis, and year 1, 5 and 10 using LC-MS/MS. 1,25(OH)2D was measured at diagnosis and year 1 using RIA. Linear mixed effects models were used to study vitamin D levels serially. We had fixed effects for time, and patients modelled as a random effect. We tested the hypothesis that percentage of patients achieving Dtotal≥ 50 nmol/l during follow-up was 90%. Analyses of associations between Dtotaland DAS28-CRP during the disease-course were adjusted for age, sex, symptom-duration prior to diagnosis and season of diagnosis.Results:Median Dtotalat baseline was 53 nmol/l (IQR 36-567.8). Dtotalincreased significantly during follow-up, independently of level at diagnosis (p<0.001). Individuals achieving Dtotal≥50nmol/l during follow-up was 80-87%, but not as high as 90% at year 1 and 5, p<0.002. DAS28-CRP during disease-course was inversely associated with Dtotaltrajectories only in crude (β-coefficient (β) -0.0034, 95%CI (-0.007; -0.0002) p=0.039) and partially adjusted analyses (β -0.003, 95%CI (-0.007; -0.002) p=0.04). Estimate was left insignificant in fully adjusted analyses (β -0.003, 95%CI (-0.0006; 0.0001) p=0.06). 1,25(OH)2D levels did not change significantly during follow-up (p=1.00).Conclusion:Dtotalincreased significantly during follow-up, but fewer than 90% achieved the recommended 50 nmol/l at year 1 and 5. Disease activity during follow-up was associated with Dtotaltrajectories only in partially adjusted analyses, while adjustment for possible confounders left estimates insignificant. Results suggest vitamin D supplementation to be recommended in all RA patients.References:Reference List[1]Herly M, Stengaard-Pedersen K, Vestergaard P, et al. The D-vitamin metabolite 1,25(OH)2 D in serum is associated with disease activity and Anti-Citrullinated Protein Antibodies in active and treatment naive, early Rheumatoid Arthritis Patients.Scand J Immunol2018;88(3):e12704. doi: 10.1111/sji.12704[2]Mouterde G, Gamon E, Rincheval N, et al. Association between Vitamin D deficiency and disease activity, disability and radiographic progression in early rheumatoid arthritis. The ESPOIR cohort.J Rheumatol2019 doi: 10.3899/jrheum.190795Disclosure of Interests:Mette Herly Grant/research support from: Pfizer Denmark - “Unrestricted Grant” for PhD projectDanish Rheumatism Association, Research Grant, Speakers bureau: Speaker for Danish Rheumatism Association, Kristian Stengaard-Pedersen: None declared, Peter Vestergaard: None declared, Robin Christensen: None declared, Sören Möller: None declared, Mikkel Ǿstergaard Grant/research support from: AbbVie, Bristol-Myers Squibb, Celgene, Merck, and Novartis, Consultant of: AbbVie, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Novo Nordisk, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB, Speakers bureau: AbbVie, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Novo Nordisk, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB, Peter Junker: None declared, Merete L. Hetland Grant/research support from: BMS, MSD, AbbVie, Roche, Novartis, Biogen and Pfizer, Consultant of: Eli Lilly, Speakers bureau: Orion Pharma, Biogen, Pfizer, CellTrion, Merck and Samsung Bioepis, Kim Hørslev-Petersen Grant/research support from: Pfizer (Travel expences), Torkell Ellingsen: None declared

Disease activity and disability in women and men with early rheumatoid arthritis: An 8-year follow-up of the Swedish TIRA project

2012 ◽  
pp. n/a-n/a ◽  
Author(s):  
Eva Hallert ◽  
Mathilda Björk ◽  
Örjan Dahlström ◽  
Thomas Skogh ◽  
Ingrid Thyberg
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Early Rheumatoid Arthritis
Sign in / Sign up

Export Citation Format

Share Document