Disease-modifying anti-rheumatic drug usage, prescribing patterns and disease activity in rheumatoid arthritis patients in community-based practice

2010 ◽  
Vol 41 (6) ◽  
pp. 450-455 ◽  
Author(s):  
K. Montag ◽  
M. Gingold ◽  
A. Boers ◽  
G. Littlejohn
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Prescribing Patterns ◽  
Drug Usage ◽  
Community Based ◽  
Disease Modifying ◽  
Rheumatic Drug

PP001 Ultrasound To Guide Treatment Decisions In Rheumatoid Arthritis

2017 ◽  
Vol 33 (S1) ◽  
pp. 67-67
Author(s):  
E Simpson ◽  
Matt Stevenson ◽  
Emma Hock ◽  
Ruth Wong ◽  
R Wakefield ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Treatment Response ◽  
Clinical Examination ◽  
Treatment Strategies ◽  
Cost Effective ◽  
Treatment Decisions ◽  
Potential Cost ◽  
Disease Modifying ◽  
Rheumatic Drug

INTRODUCTION:Ultrasound (US) detects synovitis more accurately than clinical examination (CE) in people with rheumatoid arthritis (RA). This review aimed to investigate the use of US, compared to CE alone, in treatment strategies for RA, and to estimate its potential to be cost-effective in making treatment decisions.METHODS:A systematic review was conducted of studies: investigating RA treatment response or strategies that compared US with CE-assessed synovitis; and of tapering RA treatment (1). A model was constructed to investigate the potential cost-effectiveness of US in (i) selecting patients suitable for treatment tapering; and (ii) avoiding treatment escalation (2).RESULTS:Seven prospective cohort studies suggested US-detected synovitis was significantly associated with a treatment response or tapering failure, whereas in most cases clinical examination alone was not. Two randomized controlled trials (RCTs) identified suggested that US added to the Disease Activity Index (DAS)-based treatment strategies but did not significantly improve primary outcomes, but was associated with improved rate of DAS remission. The evidence showed that some patients (proportions varied widely) who had achieved low disease activity could have treatment tapered, with no, or little, short-term harm to the patient.The model estimated that an average reduction of 2.5 percent in the costs of biological disease-modifying anti-rheumatic drug (bDMARDs) was sufficient to cover the costs of performing US every three months. This value increased to 4 percent and 13 percent for the costs of conventional disease-modifying anti-rheumatic drug (cDMARDs) depending on the assumed regimen.CONCLUSIONS:Use of US to monitor synovitis could potentially be a cost-effective approach, given that low proportions of patients for whom clinicians consider amending treatment, would need to taper treatment, or remain on therapy without escalation. US could provide clinicians with more confidence in reducing the drug burden. However, there is considerable uncertainty in this conclusion due to lack of robust data relating to key parameters.

scholarly journals Prediction of remission and low disease activity in disease-modifying anti-rheumatic drug-refractory patients with rheumatoid arthritis treated with golimumab

Rheumatology ◽  
2016 ◽  
Vol 55 (8) ◽  
pp. 1466-1476 ◽  
Author(s):  
Nathan Vastesaeger ◽  
Abraham Garcia Kutzbach ◽  
Howard Amital ◽  
Karel Pavelka ◽  
María Alicia Lazaro ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Low Disease Activity ◽  
Disease Modifying ◽  
Rheumatic Drug

scholarly journals Lack of association between CYB5A gene rs1790834 polymorphism and the response to leflunomide in women with rheumatoid arthritis

2021 ◽  
Author(s):  
Małgorzata Łączna ◽  
Damian Malinowski ◽  
Agnieszka Paradowska-Gorycka ◽  
Krzysztof Safranow ◽  
Violetta Dziedziejko ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Antirheumatic Drug ◽  
Disease Modifying ◽  
Individual Disease ◽  
Disease Modifying Antirheumatic Drug

Abstract Aim Leflunomide is a disease-modifying antirheumatic drug used in therapy for rheumatoid arthritis (RA). Previous studies indicated that oestrogens and androgens may affect the response to leflunomide in RA patients. The synthesis of androgens is regulated by cytochrome CYB5A. The aim of this study was to examine the association between the CYB5A gene rs1790834 polymorphism and the response to leflunomide in women with RA. Methods The study included 111 women diagnosed with RA. Leflunomide was administered in monotherapy at a dose of 20 mg/day. All patients underwent a monthly evaluation for 12 months after the initiation of treatment with leflunomide. Results After 12 months of therapy, the changes in individual disease activity parameters, such as: DAS28, ESR, CRP and VAS, were not statistically significantly different between rs1790834 genotypes in the Kruskal–Wallis test. Conclusions The results of our study suggest lack of statistically significant association between the CYB5A gene rs1790834 polymorphism and the response to leflunomide in women with RA.

scholarly journals FRI0651-HPR A RANDOMIZED PROSPECTIVE OPEN-LABEL CONTROLLED TRIAL COMPARING THE PERFORMANCE OF A CONNECTED MONITORING INTERFACE IN PATIENTS WITH RHEUMATOID ARTHRITIS VERSUS PHYSICAL ROUTINE MONITORING

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 929.1-930
Author(s):  
Y. M. Pers ◽  
V. Valsecchi ◽  
T. Mura ◽  
S. Aouinti ◽  
N. Filippi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Rheumatic Diseases ◽  
Tight Control ◽  
Link Type ◽  
Functional Scores ◽  
Monitoring Group ◽  
Disease Modifying

Background:Telemedicine has found wider application in chronic diseases for encouraging tight home-monitoring in order to improve patients’ outcome (Smolen et al. 2017).In previous studies, a high feasibility and high patient-satisfaction rate was found as well as the evidence for a superior or equal effectiveness of telemedicine compared to the standard face-to-face approach, however the results were weakened by some methodological biases and wide heterogeneity of interventions, thus preventing to draw definitive conclusions (Piga et al. 2017; Najm, Gossec, et al. 2019).Objectives:In rheumatoid arthritis (RA), telemedicine may allow a tight control of disease activity while reducing hospital visits. We developed a smartphone application connected with a physician’s interface to monitor RA patients. We aimed to assess the performance of this e-Health solution in comparison with routine practice in the management of patients with RA.Methods:A 6-month pragmatic, randomized, controlled, prospective, clinical trial was conducted in RA patients with high to moderate disease activity starting a new Disease Modifying Anti-Rheumatic Drug (DMARD) therapy. Two groups were established: “connected monitoring” and “conventional monitoring”. The primary outcome was the number of physical visits between baseline and 6 months. Secondary outcomes included adherence, satisfaction, changes in clinical, functional, and health status scores (SF-12).Results:Of the 94 randomized patients, 89 completed study: 44 in the “conventional monitoring” arm and 45 in the “connected monitoring” arm. The total number of physical visits between baseline and 6 month was significantly lower in the “connected monitoring” group (0.42 ± 0.58 versus 1.93 ± 0.55; p<0.05). No differences between groups were observed in the clinical and functional scores. A better quality of life for SF-12 subscores (Role-Physical, Social-Functioning and Role-Emotional) were found in the “connected monitoring” group.Conclusion:According to our results, a connected monitoring reduces the number of physical visits while maintaining a tight control of disease activity and improving quality of life in patients with RA starting a new treatment.References:[1] Najm, Aurelie, Laure Gossec, Catherine Weill, David Benoist, Francis Berenbaum, and Elena Nikiphorou. 2019. “Mobile Health Apps for Self-Management of Rheumatic and Musculoskeletal Diseases: Systematic Literature Review.”JMIR MHealth and UHealth7 (11): e14730.https://doi.org/10.2196/14730.[2] Piga, Matteo, Ignazio Cangemi, Alessandro Mathieu, and Alberto Cauli. 2017. “Telemedicine for Patients with Rheumatic Diseases: Systematic Review and Proposal for Research Agenda.”Seminars in Arthritis and Rheumatism47 (1): 121–28.https://doi.org/10.1016/j.semarthrit.2017.03.014.[3] Smolen, Josef S, Robert Landewe, Johannes Bijlsma, Gerd Burmester, Katerina Chatzidionysiou, Maxime Dougados, Jackie Nam, et al. 2017. “EULAR Recommendations for the Management of Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: 2016 Update.”Annals of the Rheumatic Diseases76 (6): 960–77.https://doi.org/10.1136/annrheumdis-2016-210715.Disclosure of Interests:None declared

Similarity of response to biologics between elderly-onset rheumatoid arthritis (EORA) and non-EORA elderly patients: from the FIRST registry

2021 ◽  
pp. jrheum.201135
Author(s):  
Sae Ochi ◽  
Fumitaka Mizoguchi ◽  
Kazuhisa Nakano ◽  
Yoshiya Tanaka
Keyword(s):  
Rheumatoid Arthritis ◽  
Elderly Patients ◽  
Disease Activity ◽  
Trajectory Analysis ◽  
Response Patterns ◽  
Efficacy And Safety ◽  
Significant Difference ◽  
Elderly Onset ◽  
Disease Modifying ◽  
Elderly Onset Rheumatoid Arthritis

Objective Increasing numbers of patients are developing rheumatoid arthritis (RA) at an older age, and optimal treatment of elderly-onset RA (EORA) patients is attracting greater attention. This study aimed to analyze the efficacy and safety of biological/targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs) in EORA and non-EORA elderly patients. Methods A cohort of RA patients treated with b/tsDMARDs were retrospectively analyzed. Among patients who were ≥60 years old, those who developed RA after age 60 years were categorized as EORA, while others were categorized as non-EORA elderly. Disease activity were compared between the EORA and non-EORA elderly groups. Results In total, 1,040 patients were categorized as EORA and 710 as non-EORA elderly. There were not significant differences in characteristics at baseline between the two groups. The proportion of patients with low and high disease activity was comparable at week 2, 22 and 54 between in the EORA and the non-EORA elderly group. There was not significant difference in reasons of the discontinuation of b/tsDMARDs between the two groups. Elderly onset did not affect changes in CDAI and HAQ-DI as well as reasons of the discontinuation between the two groups. The trajectory analysis on CDAI-responses to b/tsDMARDs for 54 weeks identified three response patterns. The proportions of patients categorized into each group and CDAI-response trajectories to b/tsDMARDs were very similar between EORA and non-EORA elderly patients. Conclusion CDAI response patterns to b/tsDMARDs and hazard ratio of adverse events were similar between EORA and non-EORA elderly patients.

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