2018
DOI: 10.1136/annrheumdis-2018-213502
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Predictors of disease activity and structural progression after treatment with adalimumab plus methotrexate or continued methotrexate monotherapy in patients with early rheumatoid arthritis and suboptimal response to methotrexate

Abstract: ObjectivesMethotrexate is considered to be first-line therapy for rheumatoid arthritis (RA). However, a substantial proportion of treated patients do not achieve the desired goals of therapy. This analysis aimed to identify predictors of insufficient response to methotrexate in patients with early RA.MethodsThe Optimal Protocol for Treatment Initiation with Methotrexate and Adalimumab (OPTIMA) and PREMIER studies in patients with RA for <1 and <3 years, respectively, examined the efficacy of methotrexate and a… Show more

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Cited by 28 publications
(22 citation statements)
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“…We externally validated the model for the first time in its entirety as, besides the clinical and laboratory predictors, the lifestyle predictors (BMI and smoking) were also examined in the U-Act-Early cohort (as opposed to the initial validation in the MTX-Rotterdam cohort, which lacked the life-style predictors) [ 9 ]. The strongest predictor was high disease activity at baseline (DAS28 > 5.1) confirming previous findings [ 7 , 18 ]. Due to differences in treatment intensities (i.e., MTX dose and co-medication) between the derivation and the validation cohort, we investigated whether the model was applicable at 6 months despite step-up treatments after the 3-month mark.…”
Section: Discussionsupporting
confidence: 89%
“…We externally validated the model for the first time in its entirety as, besides the clinical and laboratory predictors, the lifestyle predictors (BMI and smoking) were also examined in the U-Act-Early cohort (as opposed to the initial validation in the MTX-Rotterdam cohort, which lacked the life-style predictors) [ 9 ]. The strongest predictor was high disease activity at baseline (DAS28 > 5.1) confirming previous findings [ 7 , 18 ]. Due to differences in treatment intensities (i.e., MTX dose and co-medication) between the derivation and the validation cohort, we investigated whether the model was applicable at 6 months despite step-up treatments after the 3-month mark.…”
Section: Discussionsupporting
confidence: 89%
“…Increased disease activity at baseline is also associated with disease activity at 6 months and radiographic progression. This was shown by the ASPIRE, OPTIMA and PREMIER post hoc analysis, which revealed that baseline disease activity by composite measures was the strongest predictor of insufficient response to MTX and radiographic progression at 6 months as well as at 1 year 10 46 47. Taken together with our results, it is suggested that a significant portion of the progression occurs in the first few months, and baseline disease activity plays a role in clinical and radiographic response.…”
Section: Discussionsupporting
confidence: 81%
“…2010 witnessed the formal publication of treat-totarget (T2T) recommendation, and the T2T approach has been proved to yield superior outcomes to standard care in RA [14,15]. Besides, there are many factors influencing the response to RA treatment including age, gender, RA duration, rheumatoid factor (RF) and anticitrullinated peptide antibody (ACPA) status, and baseline disease activity [16,17]. To explore the effect of overlapping SS on the therapeutic response in RA patients, we used propensity score matching (PSM) to correct those possible confounding factors.…”
Section: Introductionmentioning
confidence: 99%