TY - JOUR
T1 - Treatment of rheumatoid arthritis with methotrexate alone and in combination with other conventional DMARDs using the T2T strategy. A cohort study
AU - Santos-Moreno, Pedro Iván
AU - de la Hoz-Valle, José
AU - Villarreal, Laura
AU - Palomino, Analhi
AU - Sánchez, Guillermo
AU - Castro, Carlos
N1 - Publisher Copyright:
© 2014, International League of Associations for Rheumatology (ILAR).
PY - 2015/1/27
Y1 - 2015/1/27
N2 - The aim of this study was to evaluate the effect of treatment with methotrexate (MTX), by itself or combined with other non-biological disease-modifying antirheumatic drugs (DMARDs) (methotrexate, MTX with prednisolone, MTX with leflunomide, MTX with chloroquine, and MTX with sulfasalazine) on clinimetric outcomes in a retrospective cohort with a 6-month follow-up and under a Treat to Target (T2T) approach. Patients in treatment with conventional DMARDs and classified as moderate disease activity (MDA) and high disease activity (HDA) were included. Changes in disease activity score (DAS28), health assessment questionnaire (HAQ), tender joint count (TJC), and swollen joint count (SJC) are compared using the Wilcoxon nonparametric test for paired data. Hypothesis contrasts were raised in order to look for differences between the different exposure groups and the outcomes defined by means of the Kruskal–Wallis (KW) nonparametric test. Follow-up was documented in 307 patients, including 250 (81.4 %) women. At the onset, 243 subjects (79.2 %) were classified as MDA and 64 (20.9 %) in HDA. A total of 247 subjects (80.4 %) presented some degree of improvement, with 156 subjects (51 %) entering remission, which is a significant number (p value = 0.047). There were no differences in the level of severity between the treatment groups (p = 0.98). This study, developed in a cohort of patients with RA with moderate or severe disease activity who were treated with MTX by itself or combined with other non-biological DMARDs under T2T strategy, showed a decrease in the severity of disease activity in 80 % of patients. The difference between monotherapy (MTX) and the combinations with other non-biological DMARDs could not be established.
AB - The aim of this study was to evaluate the effect of treatment with methotrexate (MTX), by itself or combined with other non-biological disease-modifying antirheumatic drugs (DMARDs) (methotrexate, MTX with prednisolone, MTX with leflunomide, MTX with chloroquine, and MTX with sulfasalazine) on clinimetric outcomes in a retrospective cohort with a 6-month follow-up and under a Treat to Target (T2T) approach. Patients in treatment with conventional DMARDs and classified as moderate disease activity (MDA) and high disease activity (HDA) were included. Changes in disease activity score (DAS28), health assessment questionnaire (HAQ), tender joint count (TJC), and swollen joint count (SJC) are compared using the Wilcoxon nonparametric test for paired data. Hypothesis contrasts were raised in order to look for differences between the different exposure groups and the outcomes defined by means of the Kruskal–Wallis (KW) nonparametric test. Follow-up was documented in 307 patients, including 250 (81.4 %) women. At the onset, 243 subjects (79.2 %) were classified as MDA and 64 (20.9 %) in HDA. A total of 247 subjects (80.4 %) presented some degree of improvement, with 156 subjects (51 %) entering remission, which is a significant number (p value = 0.047). There were no differences in the level of severity between the treatment groups (p = 0.98). This study, developed in a cohort of patients with RA with moderate or severe disease activity who were treated with MTX by itself or combined with other non-biological DMARDs under T2T strategy, showed a decrease in the severity of disease activity in 80 % of patients. The difference between monotherapy (MTX) and the combinations with other non-biological DMARDs could not be established.
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U2 - 10.1007/s10067-014-2794-9
DO - 10.1007/s10067-014-2794-9
M3 - Research Article
C2 - 25318612
AN - SCOPUS:84925520080
SN - 0770-3198
VL - 34
SP - 215
EP - 220
JO - Clinical Rheumatology
JF - Clinical Rheumatology
IS - 2
ER -