Adherence of Italian rheumatologists to the EULAR recommendations and outcomes in early rheumatoid arthritis patients after starting conventional DMARDs: Methotrexate in Italian patients wiTh Rheumatoid Arthritis (the MITRA study). A cohort study of the Italian Society for Rheumatology.
Clin Exp Rheumatol
; 40(9): 1693-1700, 2022 Sep.
Article
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| MEDLINE
| ID: mdl-35084309
ABSTRACT
OBJECTIVES:
The aim of this study was to assess the real-life adherence of Italian rheumatologist to the 2013 EULAR recommendations and treatment outcome in rheumatoid arthritis (RA) patients who started a conventional synthetic disease-modifying anti-rheumatic drug (csDMARD).METHODS:
The MITRA study is an Italian multicentre observational cohort focused on treatment naïve RA patients with early diagnosis recruited in an 18-month period starting from 2015. The data related to treatment with csDMARDs during the following 12 months follow-up were presented in this paper.RESULTS:
Two-hundred and fifty-nine RA patients from MITRA cohort who had a follow-up visit and started a csDMARD were included in the prospective analysis. Methotrexate was started as first conventional DMARD in 224 (86.4%) patients. During the first year after starting conventional DMARDs, 175 (67.6%) RA patients reached the pre-specified target, which was DAS28 remission (<2.6) for 112 (43.2%) patients and LDA (<3.2) for 63 (24.3%) patients. Factors that negatively impacted the target achievement were fibromyalgia (HR 0.2 [0.05-0.81]), HAQ-DI (HR 0.72 [0.56-0.93]) and ESR (HR 0.99 [0.99-1]). Globally, 33 (12.7%) patients started a biologic DMARD, while 61 out of 84 (72.6%) patients who had never reached the target remained on conventional DMARD. One-hundred and ninety-three adverse events (AEs) were recorded, the majority classified as mild (91 cases, 51%).CONCLUSIONS:
A high proportion of RA patients achieved the target during the first-year follow-up. However, a considerable portion of RA patients did not start a biological drug although the target was never reached. AEs remain frequent with conventional DMARDs, but the majority were mild.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Artritis Reumatoide
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Reumatología
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Productos Biológicos
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Antirreumáticos
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
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Guideline
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Incidence_studies
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Observational_studies
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Risk_factors_studies
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Screening_studies
Límite:
Humans
Idioma:
En
Revista:
Clin Exp Rheumatol
Año:
2022
Tipo del documento:
Article
País de afiliación:
Italia