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Tight control treat-to-target approach for early rheumatoid arthritis patients to measure patient-reported outcomes

Tight control treat-to-target approach for early rheumatoid arthritis patients to measure patient-reported outcomes Tight control treat-to-target approach for early rheumatoid arthritis patients to measure patient-reported outcomes
Tight control treat-to-target approach for early rheumatoid arthritis patients to measure patient-reported outcomes Tight control treat-to-target approach for early rheumatoid arthritis patients to measure patient-reported outcomes

What's new?

Out of the patient-reported outcomes (PROs); only vitality and emotional role functioning are connected with higher remission rates in initial RA revealing patients’ certain personality traits or more positive attitude to life.

In early rheumatoid arthritis (ERA) patient, identification of prognostic factors for remission is clinically crucial and beneficial. Therefore, patient-reported outcomes (PROs) could be used as predictors of remission.

Kuusal L and colleagues conducted a randomized clinical trial involving 99 untreated ERA patients. They received a remission-targeted treatment which included three disease-modifying anti-rheumatic drugs (DMARDs) and prednisolone for 24 months along with initial six months' dose of either infliximab or placebo. The PROs measured at baseline were: 1) Eight Short Form 36 questionnaire (SF-36) dimensions, 2) Patient’s global assessment [PGA, visual analogue scale (VAS)], 3) Health Assessment Questionnaire (HAQ), and 4) Pain VAS. Multivariable-adjusted regression models were used to identify the PROs, which independently predicted modified American College of Rheumatology remission at two years.

Follow-up data at two years found in remission was 92% (93 patients), and 62% (58 patients). At baseline, patients who achieved remission got high radiological score (p = 0.04), lower tender joint count (p = 0.001), lower PGA (p = 0.005) and physician’s global assessment (p = 0.019), lower HAQ (p = 0.016), less morning stiffness (p = 0.009), and had significantly higher scores (seven out of eight SF-36 dimensions compared with patients who did not. In multivariable models that included all PROs, remission was associated with SF-36 dimension's higher vitality (odds ratio 2.01; 95% confidence interval 1.19–3.39) and better emotional role functioning (odds ratio 1.64; 95% confidence interval 1.01–2.68). Overall, PGA, pain VAS, HAQ and other SF-36 dimensions were not associated with remission.

Therefore, it was concluded that self-reported vitality and better emotional role functioning criteria were important PROs to predict the remission of ERA.

Source:

Rheumatology International

Article:

Patient-reported outcomes as predictors of remission in early rheumatoid arthritis patients treated with tight control treat-to-target approach

Authors:

Laura Kuusal et al.

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