Patients lacking classical poor prognostic markers might also benefit from a step-down glucocorticoid bridging scheme in early rheumatoid arthritis: week 16 results from the randomized multicenter CareRA trial
Considering a lack of efficacy data in patients with early rheumatoid arthritis (eRA) presenting without classical markers of poor prognosis, we compared methotrexate (MTX) with or without step-down glucocorticoids in the CareRA trial. Disease-modifying antirheumatic drug-naïve patients with eRA wer...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Verschueren, Patrick [verfasserIn] |
|---|
| Format: |
Artikel |
|---|---|
| Sprache: |
Englisch |
| Erschienen: |
2015 |
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| Rechteinformationen: |
Nutzungsrecht: © Verschueren et al.; licensee BioMed Central. 2015 |
|---|
| Schlagwörter: |
Antirheumatic Agents - therapeutic use Arthritis, Rheumatoid - drug therapy Glucocorticoids - therapeutic use Arthritis, Rheumatoid - diagnosis |
|---|
| Übergeordnetes Werk: |
Enthalten in: Arthritis research & therapy - London : BioMed Central, 2003, 17(2015), 1, Seite 97 |
|---|---|
| Übergeordnetes Werk: |
volume:17 ; year:2015 ; number:1 ; pages:97 |
| Links: |
|---|
| DOI / URN: |
10.1186/s13075-015-0611-8 |
|---|
| Katalog-ID: |
OLC1961018969 |
|---|
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| 245 | 1 | 0 | |a Patients lacking classical poor prognostic markers might also benefit from a step-down glucocorticoid bridging scheme in early rheumatoid arthritis: week 16 results from the randomized multicenter CareRA trial |
| 264 | 1 | |c 2015 | |
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| 520 | |a Considering a lack of efficacy data in patients with early rheumatoid arthritis (eRA) presenting without classical markers of poor prognosis, we compared methotrexate (MTX) with or without step-down glucocorticoids in the CareRA trial. Disease-modifying antirheumatic drug-naïve patients with eRA were stratified into a low-risk group based on prognostic markers that included non-erosiveness, anti-citrullinated protein antibodies and rheumatoid factor negativity and low disease activity (Disease Activity Score in 28 joints based on C-reactive protein (DAS28(CRP)) ≤3.2). Patients were randomized to 15 mg of MTX weekly (MTX with tight step-up (MTX-TSU)) or 15 mg of MTX weekly with prednisone bridging, starting at 30 mg and tapered to 5 mg daily from week 6 (COmbinatie therapie bij Reumatoïde Artritis (COBRA Slim)). A TSU approach was applied. Outcomes assessed were DAS28(CRP)-determined remission, cumulative disease activity, Health Assessment Questionnaire (HAQ) scores and adverse events (AEs) after 16 treatment weeks. We analyzed 43 COBRA Slim and 47 MTX-TSU patients and found that 65.1% in the COBRA Slim group and 46.8% in the MTX-TSU group reached remission (P = 0.081). Mean ± standard deviation area under the curve values of DAS28(CRP) were 13.84 ± 4.58 and 11.18 ± 4.25 for the MTX-TSU and COBRA Slim patients, respectively (P = 0.006). More COBRA Slim patients had an HAQ score of 0 (51.2% versus 23.4%, P = 0.006) at week 16. Therapy-related AEs between groups did not differ. In patients with low-risk eRA, MTX with step-down glucocorticoid bridging seems more efficacious than MTX step-up monotherapy, with a comparable number of AEs observed over the first 16 treatment weeks. EU Clinical Trials Register Identifier: EudraCT number 2008-007225-39 . Registered 5 November 2008. | ||
| 540 | |a Nutzungsrecht: © Verschueren et al.; licensee BioMed Central. 2015 | ||
| 650 | 4 | |a Antirheumatic Agents - therapeutic use | |
| 650 | 4 | |a Arthritis, Rheumatoid - drug therapy | |
| 650 | 4 | |a Glucocorticoids - therapeutic use | |
| 650 | 4 | |a Arthritis, Rheumatoid - diagnosis | |
| 650 | 4 | |a Methotrexate - therapeutic use | |
| 650 | 4 | |a C-Reactive Protein - analysis | |
| 650 | 4 | |a Arthritis, Rheumatoid - blood | |
| 650 | 4 | |a Biomarkers - blood | |
| 700 | 1 | |a De Cock, Diederik |4 oth | |
| 700 | 1 | |a Corluy, Luk |4 oth | |
| 700 | 1 | |a Joos, Rik |4 oth | |
| 700 | 1 | |a Langenaken, Christine |4 oth | |
| 700 | 1 | |a Taelman, Veerle |4 oth | |
| 700 | 1 | |a Raeman, Frank |4 oth | |
| 700 | 1 | |a Ravelingien, Isabelle |4 oth | |
| 700 | 1 | |a Vandevyvere, Klaas |4 oth | |
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| 700 | 1 | |a Geusens, Piet |4 oth | |
| 700 | 1 | |a Vanhoof, Johan |4 oth | |
| 700 | 1 | |a Durnez, Anne |4 oth | |
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10.1186/s13075-015-0611-8 doi PQ20160430 (DE-627)OLC1961018969 (DE-599)GBVOLC1961018969 (PRQ)c1801-443a00e464e39a8efa71817ba0791217d599d2394a6e6f82fb21b77c9e3602063 (KEY)0427448220150000017000100097patientslackingclassicalpoorprognosticmarkersmight DE-627 ger DE-627 rakwb eng 610 DNB Verschueren, Patrick verfasserin aut Patients lacking classical poor prognostic markers might also benefit from a step-down glucocorticoid bridging scheme in early rheumatoid arthritis: week 16 results from the randomized multicenter CareRA trial 2015 Text txt rdacontent ohne Hilfsmittel zu benutzen n rdamedia Band nc rdacarrier Considering a lack of efficacy data in patients with early rheumatoid arthritis (eRA) presenting without classical markers of poor prognosis, we compared methotrexate (MTX) with or without step-down glucocorticoids in the CareRA trial. Disease-modifying antirheumatic drug-naïve patients with eRA were stratified into a low-risk group based on prognostic markers that included non-erosiveness, anti-citrullinated protein antibodies and rheumatoid factor negativity and low disease activity (Disease Activity Score in 28 joints based on C-reactive protein (DAS28(CRP)) ≤3.2). Patients were randomized to 15 mg of MTX weekly (MTX with tight step-up (MTX-TSU)) or 15 mg of MTX weekly with prednisone bridging, starting at 30 mg and tapered to 5 mg daily from week 6 (COmbinatie therapie bij Reumatoïde Artritis (COBRA Slim)). A TSU approach was applied. Outcomes assessed were DAS28(CRP)-determined remission, cumulative disease activity, Health Assessment Questionnaire (HAQ) scores and adverse events (AEs) after 16 treatment weeks. We analyzed 43 COBRA Slim and 47 MTX-TSU patients and found that 65.1% in the COBRA Slim group and 46.8% in the MTX-TSU group reached remission (P = 0.081). Mean ± standard deviation area under the curve values of DAS28(CRP) were 13.84 ± 4.58 and 11.18 ± 4.25 for the MTX-TSU and COBRA Slim patients, respectively (P = 0.006). More COBRA Slim patients had an HAQ score of 0 (51.2% versus 23.4%, P = 0.006) at week 16. Therapy-related AEs between groups did not differ. In patients with low-risk eRA, MTX with step-down glucocorticoid bridging seems more efficacious than MTX step-up monotherapy, with a comparable number of AEs observed over the first 16 treatment weeks. EU Clinical Trials Register Identifier: EudraCT number 2008-007225-39 . Registered 5 November 2008. Nutzungsrecht: © Verschueren et al.; licensee BioMed Central. 2015 Antirheumatic Agents - therapeutic use Arthritis, Rheumatoid - drug therapy Glucocorticoids - therapeutic use Arthritis, Rheumatoid - diagnosis Methotrexate - therapeutic use C-Reactive Protein - analysis Arthritis, Rheumatoid - blood Biomarkers - blood De Cock, Diederik oth Corluy, Luk oth Joos, Rik oth Langenaken, Christine oth Taelman, Veerle oth Raeman, Frank oth Ravelingien, Isabelle oth Vandevyvere, Klaas oth Lenaerts, Jan oth Geens, Elke oth Geusens, Piet oth Vanhoof, Johan oth Durnez, Anne oth Remans, Jan oth Vander Cruyssen, Bert oth Van Essche, Els oth Sileghem, An oth De Brabanter, Griet oth Joly, Johan oth Van der Elst, Kristien oth Meyfroidt, Sabrina oth Westhovens, Rene oth Enthalten in Arthritis research & therapy London : BioMed Central, 2003 17(2015), 1, Seite 97 (DE-627)363765530 (DE-600)2107602-9 (DE-576)379407604 1478-6354 nnns volume:17 year:2015 number:1 pages:97 http://dx.doi.org/10.1186/s13075-015-0611-8 Volltext http://www.ncbi.nlm.nih.gov/pubmed/25889222 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4422551&tool=pmcentrez&rendertype=abstract GBV_USEFLAG_A SYSFLAG_A GBV_OLC SSG-OLC-NED SSG-OLC-PHA SSG-OLC-DE-84 AR 17 2015 1 97 |
| spelling |
10.1186/s13075-015-0611-8 doi PQ20160430 (DE-627)OLC1961018969 (DE-599)GBVOLC1961018969 (PRQ)c1801-443a00e464e39a8efa71817ba0791217d599d2394a6e6f82fb21b77c9e3602063 (KEY)0427448220150000017000100097patientslackingclassicalpoorprognosticmarkersmight DE-627 ger DE-627 rakwb eng 610 DNB Verschueren, Patrick verfasserin aut Patients lacking classical poor prognostic markers might also benefit from a step-down glucocorticoid bridging scheme in early rheumatoid arthritis: week 16 results from the randomized multicenter CareRA trial 2015 Text txt rdacontent ohne Hilfsmittel zu benutzen n rdamedia Band nc rdacarrier Considering a lack of efficacy data in patients with early rheumatoid arthritis (eRA) presenting without classical markers of poor prognosis, we compared methotrexate (MTX) with or without step-down glucocorticoids in the CareRA trial. Disease-modifying antirheumatic drug-naïve patients with eRA were stratified into a low-risk group based on prognostic markers that included non-erosiveness, anti-citrullinated protein antibodies and rheumatoid factor negativity and low disease activity (Disease Activity Score in 28 joints based on C-reactive protein (DAS28(CRP)) ≤3.2). Patients were randomized to 15 mg of MTX weekly (MTX with tight step-up (MTX-TSU)) or 15 mg of MTX weekly with prednisone bridging, starting at 30 mg and tapered to 5 mg daily from week 6 (COmbinatie therapie bij Reumatoïde Artritis (COBRA Slim)). A TSU approach was applied. Outcomes assessed were DAS28(CRP)-determined remission, cumulative disease activity, Health Assessment Questionnaire (HAQ) scores and adverse events (AEs) after 16 treatment weeks. We analyzed 43 COBRA Slim and 47 MTX-TSU patients and found that 65.1% in the COBRA Slim group and 46.8% in the MTX-TSU group reached remission (P = 0.081). Mean ± standard deviation area under the curve values of DAS28(CRP) were 13.84 ± 4.58 and 11.18 ± 4.25 for the MTX-TSU and COBRA Slim patients, respectively (P = 0.006). More COBRA Slim patients had an HAQ score of 0 (51.2% versus 23.4%, P = 0.006) at week 16. Therapy-related AEs between groups did not differ. In patients with low-risk eRA, MTX with step-down glucocorticoid bridging seems more efficacious than MTX step-up monotherapy, with a comparable number of AEs observed over the first 16 treatment weeks. EU Clinical Trials Register Identifier: EudraCT number 2008-007225-39 . Registered 5 November 2008. Nutzungsrecht: © Verschueren et al.; licensee BioMed Central. 2015 Antirheumatic Agents - therapeutic use Arthritis, Rheumatoid - drug therapy Glucocorticoids - therapeutic use Arthritis, Rheumatoid - diagnosis Methotrexate - therapeutic use C-Reactive Protein - analysis Arthritis, Rheumatoid - blood Biomarkers - blood De Cock, Diederik oth Corluy, Luk oth Joos, Rik oth Langenaken, Christine oth Taelman, Veerle oth Raeman, Frank oth Ravelingien, Isabelle oth Vandevyvere, Klaas oth Lenaerts, Jan oth Geens, Elke oth Geusens, Piet oth Vanhoof, Johan oth Durnez, Anne oth Remans, Jan oth Vander Cruyssen, Bert oth Van Essche, Els oth Sileghem, An oth De Brabanter, Griet oth Joly, Johan oth Van der Elst, Kristien oth Meyfroidt, Sabrina oth Westhovens, Rene oth Enthalten in Arthritis research & therapy London : BioMed Central, 2003 17(2015), 1, Seite 97 (DE-627)363765530 (DE-600)2107602-9 (DE-576)379407604 1478-6354 nnns volume:17 year:2015 number:1 pages:97 http://dx.doi.org/10.1186/s13075-015-0611-8 Volltext http://www.ncbi.nlm.nih.gov/pubmed/25889222 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4422551&tool=pmcentrez&rendertype=abstract GBV_USEFLAG_A SYSFLAG_A GBV_OLC SSG-OLC-NED SSG-OLC-PHA SSG-OLC-DE-84 AR 17 2015 1 97 |
| allfields_unstemmed |
10.1186/s13075-015-0611-8 doi PQ20160430 (DE-627)OLC1961018969 (DE-599)GBVOLC1961018969 (PRQ)c1801-443a00e464e39a8efa71817ba0791217d599d2394a6e6f82fb21b77c9e3602063 (KEY)0427448220150000017000100097patientslackingclassicalpoorprognosticmarkersmight DE-627 ger DE-627 rakwb eng 610 DNB Verschueren, Patrick verfasserin aut Patients lacking classical poor prognostic markers might also benefit from a step-down glucocorticoid bridging scheme in early rheumatoid arthritis: week 16 results from the randomized multicenter CareRA trial 2015 Text txt rdacontent ohne Hilfsmittel zu benutzen n rdamedia Band nc rdacarrier Considering a lack of efficacy data in patients with early rheumatoid arthritis (eRA) presenting without classical markers of poor prognosis, we compared methotrexate (MTX) with or without step-down glucocorticoids in the CareRA trial. Disease-modifying antirheumatic drug-naïve patients with eRA were stratified into a low-risk group based on prognostic markers that included non-erosiveness, anti-citrullinated protein antibodies and rheumatoid factor negativity and low disease activity (Disease Activity Score in 28 joints based on C-reactive protein (DAS28(CRP)) ≤3.2). Patients were randomized to 15 mg of MTX weekly (MTX with tight step-up (MTX-TSU)) or 15 mg of MTX weekly with prednisone bridging, starting at 30 mg and tapered to 5 mg daily from week 6 (COmbinatie therapie bij Reumatoïde Artritis (COBRA Slim)). A TSU approach was applied. Outcomes assessed were DAS28(CRP)-determined remission, cumulative disease activity, Health Assessment Questionnaire (HAQ) scores and adverse events (AEs) after 16 treatment weeks. We analyzed 43 COBRA Slim and 47 MTX-TSU patients and found that 65.1% in the COBRA Slim group and 46.8% in the MTX-TSU group reached remission (P = 0.081). Mean ± standard deviation area under the curve values of DAS28(CRP) were 13.84 ± 4.58 and 11.18 ± 4.25 for the MTX-TSU and COBRA Slim patients, respectively (P = 0.006). More COBRA Slim patients had an HAQ score of 0 (51.2% versus 23.4%, P = 0.006) at week 16. Therapy-related AEs between groups did not differ. In patients with low-risk eRA, MTX with step-down glucocorticoid bridging seems more efficacious than MTX step-up monotherapy, with a comparable number of AEs observed over the first 16 treatment weeks. EU Clinical Trials Register Identifier: EudraCT number 2008-007225-39 . Registered 5 November 2008. Nutzungsrecht: © Verschueren et al.; licensee BioMed Central. 2015 Antirheumatic Agents - therapeutic use Arthritis, Rheumatoid - drug therapy Glucocorticoids - therapeutic use Arthritis, Rheumatoid - diagnosis Methotrexate - therapeutic use C-Reactive Protein - analysis Arthritis, Rheumatoid - blood Biomarkers - blood De Cock, Diederik oth Corluy, Luk oth Joos, Rik oth Langenaken, Christine oth Taelman, Veerle oth Raeman, Frank oth Ravelingien, Isabelle oth Vandevyvere, Klaas oth Lenaerts, Jan oth Geens, Elke oth Geusens, Piet oth Vanhoof, Johan oth Durnez, Anne oth Remans, Jan oth Vander Cruyssen, Bert oth Van Essche, Els oth Sileghem, An oth De Brabanter, Griet oth Joly, Johan oth Van der Elst, Kristien oth Meyfroidt, Sabrina oth Westhovens, Rene oth Enthalten in Arthritis research & therapy London : BioMed Central, 2003 17(2015), 1, Seite 97 (DE-627)363765530 (DE-600)2107602-9 (DE-576)379407604 1478-6354 nnns volume:17 year:2015 number:1 pages:97 http://dx.doi.org/10.1186/s13075-015-0611-8 Volltext http://www.ncbi.nlm.nih.gov/pubmed/25889222 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4422551&tool=pmcentrez&rendertype=abstract GBV_USEFLAG_A SYSFLAG_A GBV_OLC SSG-OLC-NED SSG-OLC-PHA SSG-OLC-DE-84 AR 17 2015 1 97 |
| allfieldsGer |
10.1186/s13075-015-0611-8 doi PQ20160430 (DE-627)OLC1961018969 (DE-599)GBVOLC1961018969 (PRQ)c1801-443a00e464e39a8efa71817ba0791217d599d2394a6e6f82fb21b77c9e3602063 (KEY)0427448220150000017000100097patientslackingclassicalpoorprognosticmarkersmight DE-627 ger DE-627 rakwb eng 610 DNB Verschueren, Patrick verfasserin aut Patients lacking classical poor prognostic markers might also benefit from a step-down glucocorticoid bridging scheme in early rheumatoid arthritis: week 16 results from the randomized multicenter CareRA trial 2015 Text txt rdacontent ohne Hilfsmittel zu benutzen n rdamedia Band nc rdacarrier Considering a lack of efficacy data in patients with early rheumatoid arthritis (eRA) presenting without classical markers of poor prognosis, we compared methotrexate (MTX) with or without step-down glucocorticoids in the CareRA trial. Disease-modifying antirheumatic drug-naïve patients with eRA were stratified into a low-risk group based on prognostic markers that included non-erosiveness, anti-citrullinated protein antibodies and rheumatoid factor negativity and low disease activity (Disease Activity Score in 28 joints based on C-reactive protein (DAS28(CRP)) ≤3.2). Patients were randomized to 15 mg of MTX weekly (MTX with tight step-up (MTX-TSU)) or 15 mg of MTX weekly with prednisone bridging, starting at 30 mg and tapered to 5 mg daily from week 6 (COmbinatie therapie bij Reumatoïde Artritis (COBRA Slim)). A TSU approach was applied. Outcomes assessed were DAS28(CRP)-determined remission, cumulative disease activity, Health Assessment Questionnaire (HAQ) scores and adverse events (AEs) after 16 treatment weeks. We analyzed 43 COBRA Slim and 47 MTX-TSU patients and found that 65.1% in the COBRA Slim group and 46.8% in the MTX-TSU group reached remission (P = 0.081). Mean ± standard deviation area under the curve values of DAS28(CRP) were 13.84 ± 4.58 and 11.18 ± 4.25 for the MTX-TSU and COBRA Slim patients, respectively (P = 0.006). More COBRA Slim patients had an HAQ score of 0 (51.2% versus 23.4%, P = 0.006) at week 16. Therapy-related AEs between groups did not differ. In patients with low-risk eRA, MTX with step-down glucocorticoid bridging seems more efficacious than MTX step-up monotherapy, with a comparable number of AEs observed over the first 16 treatment weeks. EU Clinical Trials Register Identifier: EudraCT number 2008-007225-39 . Registered 5 November 2008. Nutzungsrecht: © Verschueren et al.; licensee BioMed Central. 2015 Antirheumatic Agents - therapeutic use Arthritis, Rheumatoid - drug therapy Glucocorticoids - therapeutic use Arthritis, Rheumatoid - diagnosis Methotrexate - therapeutic use C-Reactive Protein - analysis Arthritis, Rheumatoid - blood Biomarkers - blood De Cock, Diederik oth Corluy, Luk oth Joos, Rik oth Langenaken, Christine oth Taelman, Veerle oth Raeman, Frank oth Ravelingien, Isabelle oth Vandevyvere, Klaas oth Lenaerts, Jan oth Geens, Elke oth Geusens, Piet oth Vanhoof, Johan oth Durnez, Anne oth Remans, Jan oth Vander Cruyssen, Bert oth Van Essche, Els oth Sileghem, An oth De Brabanter, Griet oth Joly, Johan oth Van der Elst, Kristien oth Meyfroidt, Sabrina oth Westhovens, Rene oth Enthalten in Arthritis research & therapy London : BioMed Central, 2003 17(2015), 1, Seite 97 (DE-627)363765530 (DE-600)2107602-9 (DE-576)379407604 1478-6354 nnns volume:17 year:2015 number:1 pages:97 http://dx.doi.org/10.1186/s13075-015-0611-8 Volltext http://www.ncbi.nlm.nih.gov/pubmed/25889222 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4422551&tool=pmcentrez&rendertype=abstract GBV_USEFLAG_A SYSFLAG_A GBV_OLC SSG-OLC-NED SSG-OLC-PHA SSG-OLC-DE-84 AR 17 2015 1 97 |
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10.1186/s13075-015-0611-8 doi PQ20160430 (DE-627)OLC1961018969 (DE-599)GBVOLC1961018969 (PRQ)c1801-443a00e464e39a8efa71817ba0791217d599d2394a6e6f82fb21b77c9e3602063 (KEY)0427448220150000017000100097patientslackingclassicalpoorprognosticmarkersmight DE-627 ger DE-627 rakwb eng 610 DNB Verschueren, Patrick verfasserin aut Patients lacking classical poor prognostic markers might also benefit from a step-down glucocorticoid bridging scheme in early rheumatoid arthritis: week 16 results from the randomized multicenter CareRA trial 2015 Text txt rdacontent ohne Hilfsmittel zu benutzen n rdamedia Band nc rdacarrier Considering a lack of efficacy data in patients with early rheumatoid arthritis (eRA) presenting without classical markers of poor prognosis, we compared methotrexate (MTX) with or without step-down glucocorticoids in the CareRA trial. Disease-modifying antirheumatic drug-naïve patients with eRA were stratified into a low-risk group based on prognostic markers that included non-erosiveness, anti-citrullinated protein antibodies and rheumatoid factor negativity and low disease activity (Disease Activity Score in 28 joints based on C-reactive protein (DAS28(CRP)) ≤3.2). Patients were randomized to 15 mg of MTX weekly (MTX with tight step-up (MTX-TSU)) or 15 mg of MTX weekly with prednisone bridging, starting at 30 mg and tapered to 5 mg daily from week 6 (COmbinatie therapie bij Reumatoïde Artritis (COBRA Slim)). A TSU approach was applied. Outcomes assessed were DAS28(CRP)-determined remission, cumulative disease activity, Health Assessment Questionnaire (HAQ) scores and adverse events (AEs) after 16 treatment weeks. We analyzed 43 COBRA Slim and 47 MTX-TSU patients and found that 65.1% in the COBRA Slim group and 46.8% in the MTX-TSU group reached remission (P = 0.081). Mean ± standard deviation area under the curve values of DAS28(CRP) were 13.84 ± 4.58 and 11.18 ± 4.25 for the MTX-TSU and COBRA Slim patients, respectively (P = 0.006). More COBRA Slim patients had an HAQ score of 0 (51.2% versus 23.4%, P = 0.006) at week 16. Therapy-related AEs between groups did not differ. In patients with low-risk eRA, MTX with step-down glucocorticoid bridging seems more efficacious than MTX step-up monotherapy, with a comparable number of AEs observed over the first 16 treatment weeks. EU Clinical Trials Register Identifier: EudraCT number 2008-007225-39 . Registered 5 November 2008. Nutzungsrecht: © Verschueren et al.; licensee BioMed Central. 2015 Antirheumatic Agents - therapeutic use Arthritis, Rheumatoid - drug therapy Glucocorticoids - therapeutic use Arthritis, Rheumatoid - diagnosis Methotrexate - therapeutic use C-Reactive Protein - analysis Arthritis, Rheumatoid - blood Biomarkers - blood De Cock, Diederik oth Corluy, Luk oth Joos, Rik oth Langenaken, Christine oth Taelman, Veerle oth Raeman, Frank oth Ravelingien, Isabelle oth Vandevyvere, Klaas oth Lenaerts, Jan oth Geens, Elke oth Geusens, Piet oth Vanhoof, Johan oth Durnez, Anne oth Remans, Jan oth Vander Cruyssen, Bert oth Van Essche, Els oth Sileghem, An oth De Brabanter, Griet oth Joly, Johan oth Van der Elst, Kristien oth Meyfroidt, Sabrina oth Westhovens, Rene oth Enthalten in Arthritis research & therapy London : BioMed Central, 2003 17(2015), 1, Seite 97 (DE-627)363765530 (DE-600)2107602-9 (DE-576)379407604 1478-6354 nnns volume:17 year:2015 number:1 pages:97 http://dx.doi.org/10.1186/s13075-015-0611-8 Volltext http://www.ncbi.nlm.nih.gov/pubmed/25889222 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4422551&tool=pmcentrez&rendertype=abstract GBV_USEFLAG_A SYSFLAG_A GBV_OLC SSG-OLC-NED SSG-OLC-PHA SSG-OLC-DE-84 AR 17 2015 1 97 |
| language |
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Verschueren, Patrick @@aut@@ De Cock, Diederik @@oth@@ Corluy, Luk @@oth@@ Joos, Rik @@oth@@ Langenaken, Christine @@oth@@ Taelman, Veerle @@oth@@ Raeman, Frank @@oth@@ Ravelingien, Isabelle @@oth@@ Vandevyvere, Klaas @@oth@@ Lenaerts, Jan @@oth@@ Geens, Elke @@oth@@ Geusens, Piet @@oth@@ Vanhoof, Johan @@oth@@ Durnez, Anne @@oth@@ Remans, Jan @@oth@@ Vander Cruyssen, Bert @@oth@@ Van Essche, Els @@oth@@ Sileghem, An @@oth@@ De Brabanter, Griet @@oth@@ Joly, Johan @@oth@@ Van der Elst, Kristien @@oth@@ Meyfroidt, Sabrina @@oth@@ Westhovens, Rene @@oth@@ |
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Patients lacking classical poor prognostic markers might also benefit from a step-down glucocorticoid bridging scheme in early rheumatoid arthritis: week 16 results from the randomized multicenter CareRA trial |
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Considering a lack of efficacy data in patients with early rheumatoid arthritis (eRA) presenting without classical markers of poor prognosis, we compared methotrexate (MTX) with or without step-down glucocorticoids in the CareRA trial. Disease-modifying antirheumatic drug-naïve patients with eRA were stratified into a low-risk group based on prognostic markers that included non-erosiveness, anti-citrullinated protein antibodies and rheumatoid factor negativity and low disease activity (Disease Activity Score in 28 joints based on C-reactive protein (DAS28(CRP)) ≤3.2). Patients were randomized to 15 mg of MTX weekly (MTX with tight step-up (MTX-TSU)) or 15 mg of MTX weekly with prednisone bridging, starting at 30 mg and tapered to 5 mg daily from week 6 (COmbinatie therapie bij Reumatoïde Artritis (COBRA Slim)). A TSU approach was applied. Outcomes assessed were DAS28(CRP)-determined remission, cumulative disease activity, Health Assessment Questionnaire (HAQ) scores and adverse events (AEs) after 16 treatment weeks. We analyzed 43 COBRA Slim and 47 MTX-TSU patients and found that 65.1% in the COBRA Slim group and 46.8% in the MTX-TSU group reached remission (P = 0.081). Mean ± standard deviation area under the curve values of DAS28(CRP) were 13.84 ± 4.58 and 11.18 ± 4.25 for the MTX-TSU and COBRA Slim patients, respectively (P = 0.006). More COBRA Slim patients had an HAQ score of 0 (51.2% versus 23.4%, P = 0.006) at week 16. Therapy-related AEs between groups did not differ. In patients with low-risk eRA, MTX with step-down glucocorticoid bridging seems more efficacious than MTX step-up monotherapy, with a comparable number of AEs observed over the first 16 treatment weeks. EU Clinical Trials Register Identifier: EudraCT number 2008-007225-39 . Registered 5 November 2008. |
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Considering a lack of efficacy data in patients with early rheumatoid arthritis (eRA) presenting without classical markers of poor prognosis, we compared methotrexate (MTX) with or without step-down glucocorticoids in the CareRA trial. Disease-modifying antirheumatic drug-naïve patients with eRA were stratified into a low-risk group based on prognostic markers that included non-erosiveness, anti-citrullinated protein antibodies and rheumatoid factor negativity and low disease activity (Disease Activity Score in 28 joints based on C-reactive protein (DAS28(CRP)) ≤3.2). Patients were randomized to 15 mg of MTX weekly (MTX with tight step-up (MTX-TSU)) or 15 mg of MTX weekly with prednisone bridging, starting at 30 mg and tapered to 5 mg daily from week 6 (COmbinatie therapie bij Reumatoïde Artritis (COBRA Slim)). A TSU approach was applied. Outcomes assessed were DAS28(CRP)-determined remission, cumulative disease activity, Health Assessment Questionnaire (HAQ) scores and adverse events (AEs) after 16 treatment weeks. We analyzed 43 COBRA Slim and 47 MTX-TSU patients and found that 65.1% in the COBRA Slim group and 46.8% in the MTX-TSU group reached remission (P = 0.081). Mean ± standard deviation area under the curve values of DAS28(CRP) were 13.84 ± 4.58 and 11.18 ± 4.25 for the MTX-TSU and COBRA Slim patients, respectively (P = 0.006). More COBRA Slim patients had an HAQ score of 0 (51.2% versus 23.4%, P = 0.006) at week 16. Therapy-related AEs between groups did not differ. In patients with low-risk eRA, MTX with step-down glucocorticoid bridging seems more efficacious than MTX step-up monotherapy, with a comparable number of AEs observed over the first 16 treatment weeks. EU Clinical Trials Register Identifier: EudraCT number 2008-007225-39 . Registered 5 November 2008. |
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Considering a lack of efficacy data in patients with early rheumatoid arthritis (eRA) presenting without classical markers of poor prognosis, we compared methotrexate (MTX) with or without step-down glucocorticoids in the CareRA trial. Disease-modifying antirheumatic drug-naïve patients with eRA were stratified into a low-risk group based on prognostic markers that included non-erosiveness, anti-citrullinated protein antibodies and rheumatoid factor negativity and low disease activity (Disease Activity Score in 28 joints based on C-reactive protein (DAS28(CRP)) ≤3.2). Patients were randomized to 15 mg of MTX weekly (MTX with tight step-up (MTX-TSU)) or 15 mg of MTX weekly with prednisone bridging, starting at 30 mg and tapered to 5 mg daily from week 6 (COmbinatie therapie bij Reumatoïde Artritis (COBRA Slim)). A TSU approach was applied. Outcomes assessed were DAS28(CRP)-determined remission, cumulative disease activity, Health Assessment Questionnaire (HAQ) scores and adverse events (AEs) after 16 treatment weeks. We analyzed 43 COBRA Slim and 47 MTX-TSU patients and found that 65.1% in the COBRA Slim group and 46.8% in the MTX-TSU group reached remission (P = 0.081). Mean ± standard deviation area under the curve values of DAS28(CRP) were 13.84 ± 4.58 and 11.18 ± 4.25 for the MTX-TSU and COBRA Slim patients, respectively (P = 0.006). More COBRA Slim patients had an HAQ score of 0 (51.2% versus 23.4%, P = 0.006) at week 16. Therapy-related AEs between groups did not differ. In patients with low-risk eRA, MTX with step-down glucocorticoid bridging seems more efficacious than MTX step-up monotherapy, with a comparable number of AEs observed over the first 16 treatment weeks. EU Clinical Trials Register Identifier: EudraCT number 2008-007225-39 . Registered 5 November 2008. |
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<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a2200265 4500</leader><controlfield tag="001">OLC1961018969</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230518045016.0</controlfield><controlfield tag="007">tu</controlfield><controlfield tag="008">160206s2015 xx ||||| 00| ||eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1186/s13075-015-0611-8</subfield><subfield code="2">doi</subfield></datafield><datafield tag="028" ind1="5" ind2="2"><subfield code="a">PQ20160430</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)OLC1961018969</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)GBVOLC1961018969</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(PRQ)c1801-443a00e464e39a8efa71817ba0791217d599d2394a6e6f82fb21b77c9e3602063</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(KEY)0427448220150000017000100097patientslackingclassicalpoorprognosticmarkersmight</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="082" ind1="0" ind2="4"><subfield code="a">610</subfield><subfield code="q">DNB</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Verschueren, Patrick</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Patients lacking classical poor prognostic markers might also benefit from a step-down glucocorticoid bridging scheme in early rheumatoid arthritis: week 16 results from the randomized multicenter CareRA trial</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2015</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">ohne Hilfsmittel zu benutzen</subfield><subfield code="b">n</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Band</subfield><subfield code="b">nc</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Considering a lack of efficacy data in patients with early rheumatoid arthritis (eRA) presenting without classical markers of poor prognosis, we compared methotrexate (MTX) with or without step-down glucocorticoids in the CareRA trial. Disease-modifying antirheumatic drug-naïve patients with eRA were stratified into a low-risk group based on prognostic markers that included non-erosiveness, anti-citrullinated protein antibodies and rheumatoid factor negativity and low disease activity (Disease Activity Score in 28 joints based on C-reactive protein (DAS28(CRP)) ≤3.2). Patients were randomized to 15 mg of MTX weekly (MTX with tight step-up (MTX-TSU)) or 15 mg of MTX weekly with prednisone bridging, starting at 30 mg and tapered to 5 mg daily from week 6 (COmbinatie therapie bij Reumatoïde Artritis (COBRA Slim)). A TSU approach was applied. Outcomes assessed were DAS28(CRP)-determined remission, cumulative disease activity, Health Assessment Questionnaire (HAQ) scores and adverse events (AEs) after 16 treatment weeks. We analyzed 43 COBRA Slim and 47 MTX-TSU patients and found that 65.1% in the COBRA Slim group and 46.8% in the MTX-TSU group reached remission (P = 0.081). Mean ± standard deviation area under the curve values of DAS28(CRP) were 13.84 ± 4.58 and 11.18 ± 4.25 for the MTX-TSU and COBRA Slim patients, respectively (P = 0.006). More COBRA Slim patients had an HAQ score of 0 (51.2% versus 23.4%, P = 0.006) at week 16. Therapy-related AEs between groups did not differ. In patients with low-risk eRA, MTX with step-down glucocorticoid bridging seems more efficacious than MTX step-up monotherapy, with a comparable number of AEs observed over the first 16 treatment weeks. EU Clinical Trials Register Identifier: EudraCT number 2008-007225-39 . Registered 5 November 2008.</subfield></datafield><datafield tag="540" ind1=" " ind2=" "><subfield code="a">Nutzungsrecht: © Verschueren et al.; licensee BioMed Central. 2015</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Antirheumatic Agents - therapeutic use</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Arthritis, Rheumatoid - drug therapy</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Glucocorticoids - therapeutic use</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Arthritis, Rheumatoid - diagnosis</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Methotrexate - therapeutic use</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">C-Reactive Protein - analysis</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Arthritis, Rheumatoid - blood</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Biomarkers - 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