Strategies for optimal suppression of rheumatoid arthritis
Kooij, S.M. van der
Citation
Kooij, S. M. van der. (2009, January 22). Strategies for optimal suppression of rheumatoid arthritis. Retrieved from https://hdl.handle.net/1887/13425
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Table 1. Overview of studies in early rheumatoid arthritis (symptom duration <2 years) investigating differ- ent treatment strategies with remission as treatment outcome.
Study design Patients (n)
Follow-up duration
Remission definition
Treatment strategy Remission percentage Mottonen
et al. [12]
Open randomized
195 2 years Modified ACR 1981 (Pinals) criteria
SSA + prednisone (‘single’) vs MTX + SSA + HCQ pred- nisone (’combi’)†
21% (single) vs 37% (combi)
Grigor et al. [2]
Open randomized
110 18 months DAS(44) <1.6 Routine vs intensive treat- ment (step-up strategy of SSA, then SSA + MTX + HCQ, then SSA + MTX + HCQ + prednisone)
16% (routine) vs 65% (intensive)
Verstappen et al. [13**]
Open randomized
299 2 years No swollen joints and 2 out of 3: TJC
≤3; ESR ≤20;
VASGH ≤20
Routine vs intensive treat- ment (strategy of MTX, then subcutaneous MTX, then MTX + CSA
37% (routine) vs 50% (intensive)
Proudman et al. [14]
Prospective cohort
61 3 years DAS28 <2.6 Response-driven treatment with MTX + SSA + HCQ
54% of all patients Goekoop-
Ruiterman et al. [15*]
Single blind randomized
508 2 years DAS(44) <1.6 Response-driven treat- ment strategies: (1) sequential monotherapy vs (2) step-up combination vs (3) initial combination with prednisone vs (4) initial combination with infliximab
46% (group 1) vs 38% (group 2) vs 41% (group 3) vs 42% (group 4)
Choy et al.
[16]
Double blind randomized
467 2 years DAS28 <2.6 (1) MTX vs (2) MTX + CSA vs (3) MTX + prednisone vs (4) MTX + CSA + prednisone
18% (group 1) vs 10% (group 2) vs 20% (group 3) vs 28% (group 4) Hetland et
al. [17** ]
Double blind randomized
160 2 years DAS28 <2.6 MTX + intraarticular betamethasone (‘mono’) vs MTX + CSA + intraarticular betamethasone (‘combi’)
50% (mono) vs 51% (combi)
Emery et al.
[18]
Double blind randomized
542 1 years DAS28 <2.6 MTX vs MTX + etanercept 28% (single) vs 50% (combi) ACR, American College of Rheumatology; DAS, disease activity score; CSA, cyclosporin A; ESR, erythrocyte sedimentation rate; HCQ, hydroxychloroquine; MTX, methotrexate; SSA, sulfasalazine; TJC, tender joint count; VASGH, visual analog scale global health.
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