Document Detail


Persistence on therapy is a major determinant of patient-, physician- and laboratory- reported outcomes in recent-onset rheumatoid arthritis patients.
MedLine Citation:
PMID:  20863447     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate impact of persistence on therapy on sustained major patient-, physician- and laboratory-reported outcomes (PROs, PHYROs and LAROs, respectively) in 112 recent-onset rheumatoid arthritis (RA) patients.
METHODS: At each visit a rheumatologist interviewed patients regarding therapy, morning stiffness and fatigue, scored the 28-joint disease activity score and a visual analogue scale (VAS) and determined acute-phase-reactants. The patients completed the Hispanic version of the Rheumatoid Arthritis Disease Activity Index, the Medical Outcome Short Form 36 (SF-36), the Health Assessment Questionnaire (HAQ), a pain-VAS and an overall-disease activity-VAS. Persistence was defined by self-report through directed interview. Sustained major PROs, PHYROs and LAROs were defined according to cut-offs, when maintained for ≥6 months and until last follow-up. Descriptive statistics, Kaplan-Meier curves and Cox models were used.
RESULTS: Total person-time of receiving therapy was of 375.5 patient-years. From February 2004 to June 2009, 36 (32.1%) patients were persistent. Baseline PROs/PHYROs/LAROs showed active disease and poor health status in both groups, but persistent patients (PP) had significantly lower HAQ (p=0.03) and overall-disease activity-VAS (p=0.01). More PP reached a sustained major SF-36-physical function-score (p=0.02). Persistence was the greatest independent risk factor for sustained major PROs (but absence of fatigue) and PHYROs, (p≤0.04). Time from baseline to major and sustained PROs (excluded absence of fatigue), PHYROs and C-reactive protein were shorter in PP (p≤0.04).
CONCLUSIONS: Persistence was a strong predictor for major and sustained outcomes in early RA. Favourable outcomes appear earlier in persistent than in non-persistent patients.
Authors:
I Contreras-Yáñez; J Cabiedes; A R Villa; M Rull-Gabayet; V Pascual-Ramos
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Publication Detail:
Type:  Journal Article     Date:  2010-10-22
Journal Detail:
Title:  Clinical and experimental rheumatology     Volume:  28     ISSN:  0392-856X     ISO Abbreviation:  Clin. Exp. Rheumatol.     Publication Date:    2010 Sep-Oct
Date Detail:
Created Date:  2010-10-29     Completed Date:  2010-12-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8308521     Medline TA:  Clin Exp Rheumatol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  748-51     Citation Subset:  IM    
Affiliation:
Department of Immunology and Rheumatology, Universidad Nacional Autónoma de México, México DF, México. irazucy@yahoo.com.mx
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MeSH Terms
Descriptor/Qualifier:
Adult
Antirheumatic Agents / therapeutic use*
Arthritis, Rheumatoid / blood,  drug therapy*,  physiopathology
Blood Sedimentation
C-Reactive Protein / analysis
Disability Evaluation
Female
Health Status
Humans
Joints / physiopathology
Male
Medication Adherence*
Middle Aged
Patient Satisfaction*
Quality of Life
Severity of Illness Index
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antirheumatic Agents; 9007-41-4/C-Reactive Protein

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