Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2010 Apr;69(4):689-95.
doi: 10.1136/ard.2009.108639. Epub 2009 Oct 26.

Early treatment with, and time receiving, first disease-modifying antirheumatic drug predicts long-term function in patients with inflammatory polyarthritis

Tracey M Farragher  1 , Mark Lunt, Bo Fu, Diane Bunn, Deborah P M Symmons
Affiliations
Clinical Trial

Early treatment with, and time receiving, first disease-modifying antirheumatic drug predicts long-term function in patients with inflammatory polyarthritis

Tracey M Farragher et al. Ann Rheum Dis. 2010 Apr.

Abstract

Objectives: To investigate the influence of early disease-modifying antirheumatic drug (DMARD) treatment on long-term functional outcome in patients with recent-onset inflammatory polyarthritis (IP), and the impact of the duration of first and subsequent DMARD treatment.

Methods: 642 subjects from a primary care registry of patients with new-onset IP, recruited 1990-4, were followed up for 10 years. Mean change in Health Assessment Questionnaire (HAQ) scores between baseline and 10 years were compared by time to, and time receiving, first DMARD treatment and total time receiving treatment, using linear regression. Adjustment for time-dependent confounders and censoring was performed using marginal structural weights.

Results: When adjusted for baseline and subsequent disease severity, those treated early (<6 months from symptom onset) experienced a non-significant improvement in function compared with those never treated (adjusted mean difference in change (adj_MDIC) in HAQ -0.24; 95% CI -0.58 to 0.09); and a significant benefit for each additional month of treatment within 6 months of the onset of symptoms (adj_MDIC -0.10; 95% CI -0.19 to -0.02). Patients who discontinued their first DMARD within 6 months experienced a significant deterioration in long-term function (adj_MDIC in HAQ 0.28; 95% CI 0.04 to 0.52), while those who continued their first treatment for > 3 years experienced an improvement (adj_MDIC in HAQ -0.37; 95% CI -0.77 to 0.04).

Conclusions: The importance of time to, and response to, first DMARD treatment and total duration of DMARD treatment in modifying the 10-year function in patients with IP has been demonstrated.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None.

Figures

Figure 1
Figure 1
No adjustment for confounders may lead to the incorrect inference that those patients who were receiving disease-modifying antirheumatic drug treatment at each follow-up experienced poorer function, compared with those patients not receiving treatment. HAQ, Health Assessment Questionnaire; IP, inflammatory polyarthritis.
See this image and copyright information in PMC

References

    1. Donahue KE, Gartlehner G, Jonas DE, et al. Systematic review: comparative effectiveness and harms of disease-modifying medications for rheumatoid arthritis. Ann Intern Med 2008;148:124–34 - PubMed
    1. Boers M. A call for pragmatic treatment trials in rheumatoid arthritis. Nat Clin Pract Rheumatol 2008;4:292–3 - PubMed
    1. Pincus T, Yazici Y, Sokka T. Are excellent systematic reviews of clinical trials useful for patient care? Nat Clin Pract Rheumatol 2008;4:294–5 - PubMed
    1. Smolen JS, Aletaha D. Strengths and limitations of a systematic review on DMARDs for rheumatoid arthritis. Nat Clin Pract Rheumatol 2008;4:296–7 - PubMed
    1. Weisman MH. Do all drugs and treatments for rheumatoid arthritis have the same efficacy? Nat Clin Pract Rheumatol 2008;4:298–9 - PubMed

Publication types

Substances