TY - JOUR
T1 - Diagnosis and treatment of rheumatoid arthritis in the Emilia Romagna region
T2 - A prospective population-based study
AU - Addimanda, Olga
AU - Marino, Massimiliano
AU - Farina, Ilaria
AU - Trevisani, Marica
AU - Arrigoni, Eugenio
AU - Lumetti, Federica
AU - Crescentini, Filippo
AU - Sambo, Paola
AU - Bezzi, Alessandra
AU - Bruschi, Marco
AU - Santilli, Daniele
AU - Reta, Massimo
AU - Bosi, Simona
AU - Delsante, Giovanni
AU - Girelli, Francesco
AU - Montaguti, Luca
AU - Meliconi, Riccardo
AU - Sebastiani, Marco
AU - Ferri, Clodoveo
AU - Malavolta, Nazzareno
AU - Govoni, Marcello
AU - Trombetti, Susanna
AU - de Palma, Rossana
AU - Salvarani, Carlo
PY - 2017
Y1 - 2017
N2 - Objective To perform a population-based study in rheumatoid arthritis (RA) patients, in order to evaluate the efficacy and safety of pharmacologic treatments. Methods 1087 patients with RA were enrolled; inclusion criteria were: newly diagnosed RA, already diagnosed RA with high disease activity (HDA) (DAS28≥4.2) starting biologic DMARDs (bDMARDs), already diagnosed RA with HDA continuing with conventional DMARDs (cDMARDs). The following data were collected: demographics, clinical and laboratory features, imaging and prescribed drugs. All parameters except immunology and imaging (performed yearly) were repeated at each follow-up evaluations (after 3, 6 and 12 months, and thereafter every 12 months). In order to evaluate clinical response, the EULAR response criteria were used as the gold standard. Results 414 (38.1%) newly diagnosed patients with RA, 477 (43.9%) RA patients who started bDMARDs and 196 (18.0%) RA patients who continued with cDMARDs were enrolled from April 2012 to March 2015 at 12 Rheumatology Centres in the Emilia Romagna Region. Statistical analyses showed a relative risk ratio (RRR) for moderate response of 1.65 in RA patients who started bDMARDs (p=0.16) and 2.49 for newly diagnosed RA (p=0.01). Sex, age and Health Assessment Questionnaire were not statistically significant. A RRR of 2.00 has been confirmed for RA patients who started bDMARDs (p < 0.0005) for a good response as well as 2.20 for newly diagnosed RA (p < 0.0005). An increase in adverse events among bDMARDs was found, but when looking at infections or neoplasia, no differences were highlighted between RA which started bDMARDs and RA who continued with cDMARDs. Conclusion Our results are in line with already published papers from British and Swedish Registries: a greater likelihood to have a good response is demonstrated for not longstanding RA starting cDMARDs or RA with HDA when a bDMARD is started. Also a good safety profile is demonstrated.
AB - Objective To perform a population-based study in rheumatoid arthritis (RA) patients, in order to evaluate the efficacy and safety of pharmacologic treatments. Methods 1087 patients with RA were enrolled; inclusion criteria were: newly diagnosed RA, already diagnosed RA with high disease activity (HDA) (DAS28≥4.2) starting biologic DMARDs (bDMARDs), already diagnosed RA with HDA continuing with conventional DMARDs (cDMARDs). The following data were collected: demographics, clinical and laboratory features, imaging and prescribed drugs. All parameters except immunology and imaging (performed yearly) were repeated at each follow-up evaluations (after 3, 6 and 12 months, and thereafter every 12 months). In order to evaluate clinical response, the EULAR response criteria were used as the gold standard. Results 414 (38.1%) newly diagnosed patients with RA, 477 (43.9%) RA patients who started bDMARDs and 196 (18.0%) RA patients who continued with cDMARDs were enrolled from April 2012 to March 2015 at 12 Rheumatology Centres in the Emilia Romagna Region. Statistical analyses showed a relative risk ratio (RRR) for moderate response of 1.65 in RA patients who started bDMARDs (p=0.16) and 2.49 for newly diagnosed RA (p=0.01). Sex, age and Health Assessment Questionnaire were not statistically significant. A RRR of 2.00 has been confirmed for RA patients who started bDMARDs (p < 0.0005) for a good response as well as 2.20 for newly diagnosed RA (p < 0.0005). An increase in adverse events among bDMARDs was found, but when looking at infections or neoplasia, no differences were highlighted between RA which started bDMARDs and RA who continued with cDMARDs. Conclusion Our results are in line with already published papers from British and Swedish Registries: a greater likelihood to have a good response is demonstrated for not longstanding RA starting cDMARDs or RA with HDA when a bDMARD is started. Also a good safety profile is demonstrated.
KW - Biologic DMARDS
KW - Conventional DMARDS
KW - Efficacy
KW - Rheumatoid arthritis
KW - Safety
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M3 - Article
C2 - 28134078
AN - SCOPUS:85018177866
VL - 35
SP - 201
EP - 208
JO - Clinical and Experimental Rheumatology
JF - Clinical and Experimental Rheumatology
SN - 0392-856X
IS - 2
ER -