High burden of adverse events is associated with reduced remission rates in early rheumatoid arthritis

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NEO-RACo Study Grp 2018 , ' High burden of adverse events is associated with reduced remission rates in early rheumatoid arthritis ' , Clinical Rheumatology , vol. 37 , no. 6 , pp. 1689-1694 . https://doi.org/10.1007/s10067-017-3958-1

Title: High burden of adverse events is associated with reduced remission rates in early rheumatoid arthritis
Author: NEO-RACo Study Grp
Date: 2018-06
Language: eng
Number of pages: 6
Belongs to series: Clinical Rheumatology
ISSN: 0770-3198
URI: http://hdl.handle.net/10138/302410
Abstract: Adverse events (AEs) are common during disease-modifying antirheumatic drug (DMARD) treatment, but their influence on treatment results is unclear. We studied AEs in relation to disease activity in early rheumatoid arthritis (RA). Ninety-nine patients started intensive treatment with three conventional synthetic DMARDs (csDMARDs) and oral prednisolone, and were randomized to a 6-month induction treatment with infliximab or placebo. All AEs during the first 12 months of treatment were recorded. We scored each AE based on severity (scale 1-4) and defined the burden of AEs as the sum of these scores. Patients were divided into tertiles according to the burden of AEs. As outcomes, we assessed 28-joint disease activity score (DAS28) levels and remission rates at 12 and 24 months. Three hundred thirty-one AEs in 99 patients were reported, and 27 (8%) were categorized as severe or serious. Mean burden of AEs per patient was 5.4 +/- 4.3. Seventy-nine AEs (24%) led to temporary (n = 52) or permanent (n = 27) csDMARD discontinuation. Of discontinuations, 1, 21, and 57 were detected in the first, second, and third tertiles, respectively. DAS28 remission rates decreased across tertiles at 12 months (94, 94, and 76%; p for linearity 0.029) and at 24 months (90, 86, and 70%; p for linearity 0.021). Mean DAS28 levels increased across tertiles at 12 months (1.5 +/- 1.0, 1.7 +/- 0.9, and 1.9 +/- 1.2; p for linearity 0.021) and at 24 months (1.4 +/- 0.8, 1.6 +/- 1.0, and 1.9 +/- 1.1; p for linearity 0.007). High burden of AEs is associated with higher disease activity and lower likelihood of remission in early RA.
Subject: Adverse events
Clinical trials
DMARDs
Remission
Rheumatoid arthritis
MODIFYING ANTIRHEUMATIC DRUGS
DISEASE-ACTIVITY SCORE
THERAPY
RETENTION
COHORT
TRIAL
BLIND
RACO
3121 General medicine, internal medicine and other clinical medicine
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