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Are rheumatologists adhering to the concepts window of opportunity and treat-to-target? Earlier and more intense disease-modifying anti-rheumatic drug treatment over time in patients with early arthritis in the PEARL study

1, 2, 3, 4, 5, 6, 7, 8

  1. Rheumatology Service, Hospital Clínico San Carlos, Madrid, Spain.
  2. Rheumatology Service, Hospital Universitario La Princesa, IIS-IP, Madrid, Spain.
  3. Rheumatology Service, Hospital Universitario y Politécnico La Fé, Valencia, Spain.
  4. Rheumatology Service, Hospital Universitario La Princesa, IIS-IP, Madrid, Spain.
  5. Rheumatology Service, Hospital Universitario La Princesa, IIS-IP, Madrid, Spain.
  6. Rheumatology Service, Hospital Clinico San Carlos, IdiSSC. Madrid, Spain.
  7. InMusc, Madrid, Spain.
  8. Rheumatology Service, Hospital Universitario La Princesa, IIS-IP, Madrid, Spain. isidoro.ga@ser.es

CER10574 Submission on line
2018 Vol.36, N°3 - PI 0382, PF 0388
Full Papers

Rheumatology Article

 

Abstract

OBJECTIVES:
To analyse changes over time in the treatment with disease modifying anti-rheumatic drugs and biological therapies prescribed to patients from an early arthritis register and whether these changes had an impact on their outcome.
METHODS:
This was a longitudinal retrospective 2-year study based on data collected in the PEARL study. The population was clustered in three groups depending on year of symptoms onset (2000-2004, 2005-2009, 2010-2014). Intensity of disease-modifying anti-rheumatic drug treatment was calculated and the percentage of patients receiving biological therapy during the first 2-year follow-up was collected. Disease activity and remission at the end of follow-up, as well as radiological progression were the outcomes analysed. Multivariable analyses were fitted to determine which variables including the three period times were associated with the outcomes.
RESULTS:
A significant increase in treatment intensity was observed in patients with undifferentiated arthritis, getting closer to that prescribed to patients fulfilling the 1987 RA criteria at the last period studied (2010-2014). This finding was associated with a significantly higher percentage of patients in remission and lower progression of the erosion component of the Sharp van der Heijde score.
CONCLUSIONS:
During the last 15 years, the treatment of patients with early arthritis in our hospital has been progressively increased and it has been associated with significantly better outcomes.

PMID: 29185958 [PubMed]

Received: 12/05/2017 - Accepted : 01/08/2017 - In Press: 28/11/2017 - Published: 17/05/2018