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dc.contributor.authorWalsh, David A
dc.date.accessioned2022-05-09T10:51:07Z
dc.date.available2022-05-09T10:51:07Z
dc.date.issued2010-07
dc.identifier.citationRachapalli, S. M. et al. (2010) ‘First-line DMARD choice in early rheumatoid arthritis-do prognostic factors play a role?’, RHEUMATOLOGY -LONDON THEN OXFORD- BRITISH SOCIETY FOR RHEUMATOLOGY-, 1 January, pp. 1267–1271en_US
dc.identifier.urihttp://hdl.handle.net/20.500.12904/15404
dc.description.abstractObjective: To examine if prognostic factors predict the choice of first DMARD for patients with RA. Methods: Details of 616 patients with early RA were collected from 16 centres in the UK Early Rheumatoid Arthritis Network (ERAN). Logistic regression was used to identify whether HAQ score, swollen joint count (SJC), nodules, RF, ESR, CRP and erosions on radiographs were associated with the choice of first DMARD treatment. Results: Of 616 patients, 547 (88%) were started on a DMARD, 253 (46%) on MTX, 230 (42%) on SSZ, 47 (9%) on other DMARD monotherapies and 17 (3%) on combination DMARD therapy (CoT). SSZ was started less frequently in patients with positive RF (P = 0.018; OR 0.59; 95% CI 0.38, 0.91) and high SJC (P = 0.02; OR 0.95; 95% CI 0.91, 0.99). MTX was favoured in patients with high SJC (P = 0.002; OR 1.07; 95% CI 1.02, 1.11). Non-prescription of DMARDs was associated with old age (P = 0.02; OR 0.98; 95% CI 0.96, 0.99) and low HAQ score (P = 0.009; OR 0.80; 95% CI 0.68, 0.95). None of the variables predicted CoT. All other variables and the hospital where the patient was treated were not independently associated with the choice of DMARD. Conclusions: When choosing DMARD monotherapy in early RA, rheumatologists in ERAN seem to preferentially prescribe MTX for patients with a poor prognosis and SSZ for patients with good prognosis. No DMARDs were used in older patients or in those with a low HAQ.
dc.description.urihttps://academic.oup.com/rheumatology/article/49/7/1267/1785176en_US
dc.publisherRheumatology (Oxford)en_US
dc.subjectRheumatoid arthritisen_US
dc.subjectDMARD choiceen_US
dc.subjectPrognostic factorsen_US
dc.titleFirst-line DMARD choice in early rheumatoid arthritis – do prognostic factors play a role?en_US
dc.typeArticleen_US
rioxxterms.funderDefault funderen_US
rioxxterms.identifier.projectDefault projecten_US
rioxxterms.versionNAen_US
rioxxterms.versionofrecord10.1093/rheumatology/kep389en_US
rioxxterms.typeJournal Article/Reviewen_US
refterms.dateFOA2022-05-09T10:51:07Z
refterms.panelUnspecifieden_US
refterms.dateFirstOnline2009-12
html.description.abstractObjective: To examine if prognostic factors predict the choice of first DMARD for patients with RA. Methods: Details of 616 patients with early RA were collected from 16 centres in the UK Early Rheumatoid Arthritis Network (ERAN). Logistic regression was used to identify whether HAQ score, swollen joint count (SJC), nodules, RF, ESR, CRP and erosions on radiographs were associated with the choice of first DMARD treatment. Results: Of 616 patients, 547 (88%) were started on a DMARD, 253 (46%) on MTX, 230 (42%) on SSZ, 47 (9%) on other DMARD monotherapies and 17 (3%) on combination DMARD therapy (CoT). SSZ was started less frequently in patients with positive RF (P = 0.018; OR 0.59; 95% CI 0.38, 0.91) and high SJC (P = 0.02; OR 0.95; 95% CI 0.91, 0.99). MTX was favoured in patients with high SJC (P = 0.002; OR 1.07; 95% CI 1.02, 1.11). Non-prescription of DMARDs was associated with old age (P = 0.02; OR 0.98; 95% CI 0.96, 0.99) and low HAQ score (P = 0.009; OR 0.80; 95% CI 0.68, 0.95). None of the variables predicted CoT. All other variables and the hospital where the patient was treated were not independently associated with the choice of DMARD. Conclusions: When choosing DMARD monotherapy in early RA, rheumatologists in ERAN seem to preferentially prescribe MTX for patients with a poor prognosis and SSZ for patients with good prognosis. No DMARDs were used in older patients or in those with a low HAQ.en_US
rioxxterms.funder.project94a427429a5bcfef7dd04c33360d80cden_US


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