TORNA ALL’ELENCO

Clinical characteristics of rheumatoid arthritis patients ongoing methotrexate therapy not achieving das28 “low diseases activity”: A matched case-control analysis from the MARI study in Annals of the Rheumatic Diseases

2017
ASL Torino 4

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (15)Vedi tutti...

Giusti A
RSA Villa Serena, Bologna (BO), Italy
Manara M
RSA Villa Serena, Bologna (BO), Italy
Bruschi E
RSA Villa Serena, Bologna (BO), Italy

et alii...

Abstract

Background: Methotrexate (MTX) is the DMARD of first choice in the treatment of rheumatoid arthritis (RA). Objectives: To investigate the clinical characteristics and describe therapeutic approaches in RA patients ongoing MTX not achieving a DAS28 “low disease activity” score. Methods: This is a case-control analysis including 186 patients (mean age±SD, 61±12 years, 16% males) who did not achieve a DAS28 “low disease activity” score (defined by a value ?3.2) and 558 age- and gender-frequency-matched (1:3), randomly selected controls (mean age age±SD, 61±13 years) who achieved a DAS28 “low disease activity” from the original cohort investigated in the MARI study. The MARI study enrolled RA patients on treatment for at least 12-month with MTX. Demographic, clinical, laboratory and pharmacological characteristics of patients recorded at baseline visit were considered for the current analysis. We first compared the characteristics of patients who reached the endpoint with those of subjects who did not by univariate analyses, thereafter, we performed a multivariate model to identify predictors of not achieving the endpoint. We further investigated the therapeutic approaches in patients not achieving the endpoint. Results: Compared to patients with a DAS28 ?3.2, subjects not achieving the endpoint presented with a significant higher (mean±SD) weight and BMI (DAS28 ?3.2: 25±4 versus DAS28 >3.2: 26±5, P=.022), and longer duration of symptoms (months±SD) before the RA diagnosis (11±15 versus 15±20, P=.009). A higher proportion of subjects within the group not achieving the endpoint presented with polyarticular disease (DAS28 ?3.2: 57% versus DAS28 >3.2: 96%, P<.001), erosive arthritis (49% versus 73%, P<.001), extra-articular symptoms (3% versus 10%, P<.001), positive RF test (63% versus 73%, P=.013), and increased CRP (13% versus 53%, P<.001). The proportion of patients treated with oral MTX was 25% in the subgroup with DAS28 ?3.2 and

DOI : 10.1136/annrheumdis-2017-eular.4619

Keywords

major clinical study; longitudinal study; human; gender; female; drug therapy; diagnosis; DAS28; controlled study; conference abstract; cohort analysis; clinical laboratory; case control study; body weight; body mass; adult; methotrexate; biological product; male; middle aged; prescription; randomized controlled trial; rheumatoid arthritis; univariate analysis;