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Methotrexate treatment in early psoriatic arthritis in comparison to rheumatoid arthritis: an observational nationwide study.
Lindström, Ulf; di Giuseppe, Daniela; Exarchou, Sofia; Alenius, Gerd-Marie; Olofsson, Tor; Klingberg, Eva; Jacobsson, Lennart; Askling, Johan; Wallman, Johan K.
Afiliação
  • Lindström U; Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden ulf.lindstrom@gu.se.
  • di Giuseppe D; Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
  • Exarchou S; Rheumatology, Department of Clinical Sciences, Lund University, Malmö, Sweden.
  • Alenius GM; Department of Public Health and Clinical Medicine/Rheumatology, Umeå University, Umeå, Sweden.
  • Olofsson T; Department of Clinical Sciences, Rheumatology, Lund University, Skane University Hospital, Lund, Sweden.
  • Klingberg E; Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
  • Jacobsson L; Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
  • Askling J; Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
  • Wallman JK; Department of Clinical Sciences, Rheumatology, Lund University, Skane University Hospital, Lund, Sweden.
RMD Open ; 9(2)2023 05.
Article em En | MEDLINE | ID: mdl-37173095
INTRODUCTION: We aimed to compare the proportions of patients with newly diagnosed psoriatic arthritis (PsA) and rheumatoid arthritis (RA) remaining on methotrexate (regardless of other disease-modifying antirheumatic drug (DMARD)-changes), and proportions not having started another DMARD (regardless of methotrexate discontinuation), within 2 years of starting methotrexate, as well as methotrexate effectiveness. METHODS: Patients with DMARD-naïve, newly diagnosed PsA, starting methotrexate 2011-2019, were identified from high-quality national Swedish registers and matched 1:1 to comparable patients with RA. Proportions remaining on methotrexate and not starting another DMARD were calculated. For patients with disease activity data at baseline and 6 months, response to methotrexate monotherapy was compared through logistic regression, applying non-responder imputation. RESULTS: In total, 3642/3642 patients with PsA/RA were included. Baseline patient-reported pain and global health were similar, whereas patients with RA had higher 28-joint scores and evaluator-assessed disease activity. Two years after methotrexate start, 71% of PsA vs 76% of patients with RA remained on methotrexate, 66% vs 60% had not started any other DMARD, and 77% vs 74% had not started specifically a biological or targeted synthetic DMARD. At 6 months, the proportions of patients with PsA versus RA achieving pain-scores ≤15 mm were 26% vs 36%; global health ≤20 mm: 32% vs 42%; evaluator-assessed 'remission': 20% vs 27%, with corresponding adjusted ORs (PsA vs RA) of 0.63 (95% CI 0.47 to 0.85); 0.57 (95% CI 0.42 to 0.76) and 0.54 (95% CI 0.39 to 0.75). DISCUSSION: In Swedish clinical practice, methotrexate use is similar in PsA and RA, both regarding initiation of other DMARDs and methotrexate retention. On a group level, disease activity improved during methotrexate monotherapy in both diseases, although more so in RA.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Artrite Reumatoide / Artrite Psoriásica / Antirreumáticos Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Artrite Reumatoide / Artrite Psoriásica / Antirreumáticos Idioma: En Ano de publicação: 2023 Tipo de documento: Article