دورية أكاديمية
أعرض في EDS

Daily practice feasibility and effectiveness of treating long-standing rheumatoid arthritis to target with synthetic disease-modifying antirheumatic drugs: a prospective cohort study.

التفاصيل البيبلوغرافية
العنوان: Daily practice feasibility and effectiveness of treating long-standing rheumatoid arthritis to target with synthetic disease-modifying antirheumatic drugs: a prospective cohort study.
المؤلفون: Brenol CV; Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, sala 645, Porto Alegre, RS, 90035-903, Brazil. claiton.brenol@gmail.com., da Chakr RM; Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, sala 645, Porto Alegre, RS, 90035-903, Brazil. rafaelchakr@gmail.com., Andrade NP; Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, sala 645, Porto Alegre, RS, 90035-903, Brazil. nicole.pba@gmail.com., Toni M; Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, sala 645, Porto Alegre, RS, 90035-903, Brazil. maaritoni@gmail.com., Laurindo IM; Universidade de São Paulo, Av. Dr. Arnaldo 455-3° andar, sala 3133, São Paulo, SP, 01246-903, Brazil. frlaurindo@uol.com.br., Brenol JC; Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, sala 645, Porto Alegre, RS, 90035-903, Brazil. jbrenol@brturbo.com.br., Xavier RM; Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, sala 645, Porto Alegre, RS, 90035-903, Brazil. rxavier10@gmail.com.
المصدر: Clinical rheumatology [Clin Rheumatol] 2015 Oct; Vol. 34 (10), pp. 1781-5. Date of Electronic Publication: 2015 Mar 15.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer Country of Publication: Germany NLM ID: 8211469 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1434-9949 (Electronic) Linking ISSN: 07703198 NLM ISO Abbreviation: Clin Rheumatol Subsets: MEDLINE
أسماء مطبوعة: Publication: <2008->: Heidelberg : Springer
Original Publication: Brussels : Acta Medica Belgica, [1982-
مواضيع طبية MeSH: Antirheumatic Agents/*therapeutic use , Arthritis, Rheumatoid/*drug therapy, Adult ; Aged ; Drug Therapy, Combination/methods ; Feasibility Studies ; Female ; Follow-Up Studies ; Humans ; Inflammation ; Male ; Methotrexate/administration & dosage ; Methotrexate/therapeutic use ; Middle Aged ; Prospective Studies ; Remission Induction ; Severity of Illness Index ; Sulfasalazine/administration & dosage ; Sulfasalazine/therapeutic use ; Treatment Outcome
مستخلص: To prospectively study the daily practice feasibility and effectiveness of treat-to-target (T2T) strategy with synthetic drugs aiming to maintain and achieve disease remission or low activity based on DAS28 and CDAI in long-standing rheumatoid (RA) patients. Two hundred and forty-one consecutive RA patients from Hospital de Clínicas de Porto Alegre were followed for 14 (±5.3) months. At follow-up, patients were evaluated by a rheumatologist at least once every 3 to 4 months. Treatment was adjusted following a step-up strategy, based on the disease activity scores (DAS28 and CDAI), aiming at remission (<2.6 or <2.8, respectively) or at least low disease activity (<3.2 or <10). Patients were predominantly women (84.7 %), mean age 54.9 (±11.9) years with 11.1 (±7.4) years of disease duration. At visit 4, T2T intervention significantly reduced DAS28 (4.6 ± 1.6 vs. 4.0 ± 1.5; p < 0.005), CDAI [17.8 (8.2-28.7) vs. 12.6 (5.1-22.5); p < 0.001], and HAQ (1.5 ± 0.9 vs. 1.3 ± 0.8; p = 0.002). At the end of the study, compared to the baseline scores, more patients achieved remission by DAS28 (11.6 vs. 18.6 %; p < 0.001) and CDAI (8.1 vs. 13.6 %; p < 0.001) and also low disease activity by DAS28 (9.8 vs. 13.0 %; p < 0.001) and CDAI (23.9 vs. 28.4 %; p < 0.001). Both average doses of sulfasalazine and methotrexate at visit 4 were higher (1375 vs. 1621 mg, p = 0.024; and 14.5 vs. 16.5 mg, p < 0.001, respectively). More patients were on combination therapy at the end of the follow-up (48.2 vs. 52.3 %; p < 0.001). The implementation of T2T strategy in the treatment of RA was feasible and effective in this outpatient population. The optimization of synthetic DMARDs use with dose adjustments and combinations of drugs seemed to improve disease outcome regarding disease activity and functional status.
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فهرسة مساهمة: Keywords: Cohort; Effectiveness; Feasibility; Rheumatoid arthritis; Synthetic DMARDs; Treat-to-target
المشرفين على المادة: 0 (Antirheumatic Agents)
3XC8GUZ6CB (Sulfasalazine)
YL5FZ2Y5U1 (Methotrexate)
تواريخ الأحداث: Date Created: 20150317 Date Completed: 20160727 Latest Revision: 20181113
رمز التحديث: 20240628
DOI: 10.1007/s10067-015-2915-0
PMID: 25771853
قاعدة البيانات: MEDLINE
الوصف
تدمد:1434-9949
DOI:10.1007/s10067-015-2915-0