DAS steered therapy in clinical practice; cross-sectional results from the METEOR database

BMC Musculoskeletal Disorders
Emilia GvozdenovićRobert Landewé

Abstract

Little is known on how well targeted treatment, for instance targeting towards low DAS, is implemented in clinical practice. Our aim was to evaluate treatment adjustments in response to DAS in RA patients in clinical practice. We used data from one referral centre, multiple rheumatologists, from the METEOR database. Generalized Estimating Equations (GEE) were used to assess whether in case of non-low disease activity (DAS > 2.4) treatment intensifications in DMARD therapy occurred ((change or increase in dose or number of DMARDs, including synthetic (s)DMARDs, biologic (b)DMARDs and corticosteroids compared to the visit before)). Determinants of not intensifying the treatment when DAS > 2.4 were investigated using GEE. Five thousand one hundred fifty-seven registered visits of 1202 patients were available for the analyses. A DAS > 2.4 was weakly (OR: 1.19; 95% CI 1.07-1.33) associated with a treatment intensification. In 69% (n = 3577) of the visits patients were in low disease activity. In 66% (n = 1028) of the visits with DAS > 2.4 treatment was not intensified. These patients had a higher tender joint count and received more often methotrexate plus a bDMARD, or csDMARD monotherapy, as compared to patients that received treat...Continue Reading

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Citations

Dec 4, 2019·Expert Review of Clinical Immunology·Elizabeth M A Hensor, Philip G Conaghan

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Methods Mentioned

BETA
ESR

Software Mentioned

SPSS
BeSt
METEOR
TICORA
VasPtGlobal Patient Assessment of
CAMERA
DREAM

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