The Stop Arthritis Very Early (SAVE) trial, an international multicentre, randomised, double-blind, placebo-controlled trial on glucocorticoids in very early arthritis

Machold, Klaus; Landewé, Robert; Smolen, Josef S.; Stamm, Tanja; Heijde, Désirée M van der; Verpoort, Kirsten N; Brickmann, Kerstin; Vázquez‐Mellado, Janitzia; Karateev, D.; Breedveld, Ferdinand C.; Emery, Paul; Huizinga, T.W.J.

doi:10.1136/ard.2009.122473

Cited by 113 publications

(71 citation statements)

References 38 publications

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“…The percentage (59.5 %) of early onset arthritis patients with a minimum score of 6 in the 2010 ACR/ EULAR criteria in our analysis was higher than the rate found by Cornec et al (44.2 %) in a cohort of 270 patients from Brittany/France [23]. Two publications discuss the patient's final diagnosis after following patients with recent onset rheumatoid arthritis: In the Save trial, 45.86 % were defined as rheumatoid arthritis and 20.1 % as another disease after 12 months of follow-up [24]; in the cohort of Cader et al, 42.5 % fulfilled the ACR/EULAR criteria after 18 months [25]. In summary, the rate of patients with definite RA according to the ACR/EULAR criteria in our cohort of early onset arthritis was higher than the rates observed by others.…”

Section: Discussioncontrasting

confidence: 79%

The new 2010 ACR/EULAR criteria as predictor of clinical and radiographic response in patients with early arthritis

et al. 2014

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New American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria for the classification of rheumatoid arthritis (RA) have recently been proposed. The aim of this cohort study was to examine whether fulfilling these 2010 ACR/EULAR criteria at the first visit has an impact on the clinical course and on the radiographic progression of the disease. For this observational cohort study, we included patients from the Swiss RA registry SCQM with early RA or undifferentiated arthritis (UA, disease duration ≤1 year), as defined by the treating rheumatologist, who had not received any previous disease modifying anti-rheumatic drugs (DMARDs). Patients were categorized into two groups depending on whether or not they fulfilled the 2010 ACR/EULAR criteria (≥6 points vs <6 points) at the first visit. The primary outcome measures were the evolution of the DAS 28 and of radiographic erosions as measured by the Ratingen score over time. Of the 592 patients fulfilling the inclusion criteria, 352 satisfied the 2010 ACR/EULAR criteria at baseline, whereas 240 were not classifiable as definite RA. The ACR/EULAR criteria scores correlated with disease activity at disease onset (R (2) = 0.31). DMARD treatment was subsequently initiated in all patients, mostly with methotrexate (MTX). There were no significant differences in the therapeutic strategies between patients fulfilling or not fulfilling the classification criteria. Six months after inclusion, patients fulfilling the ACR/EULAR criteria developed a 39.1 % reduction of DAS 28 scores, as compared to a 33.6 % reduction in patients not fulfilling the ACR/EULAR criteria (p = 0.0002), independently of their respective treatment strategy. Importantly, the DAS 28 scores were higher in those patients fulfilling the ACR/EULAR criteria (ACR/EULAR positive patients) throughout the observation, as compared to patients not fulfilling those (ACR/EULAR negative patients). Average radiographic progression was higher among ACR/EULAR positive than negative patients (progression of Ratingen score/year 0.50 vs 0.32, resp., p = 0.03) after 3 years of follow-up. Among early RA/UA patients, a score of the 2010 ACR/EULAR criteria sufficient to classify RA selects patients with worse clinical outcome and more radiographic progression.

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Section: Discussioncontrasting

confidence: 79%

The new 2010 ACR/EULAR criteria as predictor of clinical and radiographic response in patients with early arthritis

et al. 2014

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“…Важной задачей современ-ной ревматологии признается изучение возможностей по предотвращению развития РА у больных НПА, поскольку на этом этапе развития хронического воспалительного заболе-вания могут быть задействованы не все его патогенетические механизмы, в связи с чем данное состояние потенциально обратимо. Эта задача является весьма непростой, поскольку даже мощное противовоспалительное воздействие, напри-мер высокой дозой глюкокортикоидов (ГК) в исследовании SAVE [11] или метотрексатом в исследовании PROMPT [12], давало весьма скромный эффект. При этом на практике у больных НПА постоянно возникает вопрос о наличии по-казаний к применению базисных противовоспалительных препаратов (БПВП) и ГК, поскольку большинство из этих пациентов не имеют точного диагноза при невысокой воспа-лительной активности.…”

Section: научно-практическая ревматология 2011 № 6 16-22unclassified

Omega-3 polyunsaturated fatty acids in early undifferentiated peripheral arthritis

Каратеев¹,

Лучихина²,

Новиков³

et al. 2011

rsp

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“…Many studies show that patients with undifferentiated arthritis benefit from methotrexate (30). Studies on the role of steroids alone are not very beneficial (31). Combining multiple DMARDs or DMARDs with corticosteroids may be even more beneficial.…”

Section: Prevention Of Ramentioning

confidence: 99%

Pre-rheumatoid arthritis and its prevention

Paul¹,

Kandy²,

Krishnan³

2017

Eur J Rheumatol

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Pre-rheumatoid arthritis (pre-RA) is the preclinical period of the disease that precedes the onset of clinically apparent RA. It includes the interaction between genetic and environmental risk factors and development of disease-related autoantibodies and joint symptoms and signs, which may be considered nonspecific or unclassified for RA. A better understanding of the pre-RA stage will be useful in developing screening programs for early detection of RA. Identifying and modifying risk factors such as smoking, periodontitis, obesity, viral infections, and hormonal or dietary factors will be useful in preventing RA in susceptible population.

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The Stop Arthritis Very Early (SAVE) trial, an international multicentre, randomised, double-blind, placebo-controlled trial on glucocorticoids in very early arthritis

Abstract: Neither remission nor development of RA is delayed by GC treatment. Remission is rare in the first year of very early arthritis, occurring in <20% of the patients. Also, the need to start DMARDs was not influenced by GC treatment.

Cited by 113 publications

References 38 publications

The new 2010 ACR/EULAR criteria as predictor of clinical and radiographic response in patients with early arthritis

The new 2010 ACR/EULAR criteria as predictor of clinical and radiographic response in patients with early arthritis

Omega-3 polyunsaturated fatty acids in early undifferentiated peripheral arthritis

Pre-rheumatoid arthritis and its prevention

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