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MTX optimization or adding bDMARD equally improve disease activity in rheumatoid arthritis: results from the prospective study STRATEGE.
MTX optimization or adding bDMARD equally improve disease activity in rheumatoid arthritis: results from the prospective study STRATEGE.
- Source :
-
Rheumatology . Jan2022, Vol. 61 Issue 1, p270-280. 11p. - Publication Year :
- 2022
-
Abstract
- Objectives The STRATEGE (Therapeutic Strategy in Patients Treated With Methotrexate for Rheumatoid Arthritis) study aimed to describe treatment strategies in current practice in RA biologic DMARD (bDMARD)-naïve patients with an inadequate response to MTX therapy, and to compare clinical efficacy of the different therapeutic strategies on disease activity after 6 months. Methods The main inclusion criteria of this prospective, observational, multicentre study were confirmed RA diagnosis, treatment by MTX monotherapy and need for therapeutic management modification. Results The 722 patients included had a mean (s. d.) RA duration of 5.3 (6.7) years, a mean DAS28 of 4.0 (1.1); they were all receiving MTX monotherapy, 68% oral, at a mean dose of 15.0 (4.1) mg/week. Two major strategies were identified: (i) MTX monotherapy dose and/or route optimization (72%) and (ii) bDMARD initiation ± MTX (16%). MTX dosing was modified for 70% of patients, maintained (dose and route) for 28% of patients and interrupted for 2%. bDMARDs were started when the MTX mean dose was 17.4 mg/week, 56% parenterally; MTX was maintained concomitantly for 96% of patients. Six-month follow-up results adjusted by propensity score showed that both options were equally successful in improving disease activity and physical function, with 63 and 68% of good-to-moderate EULAR responses, respectively. Conclusion The STRATEGE study shows the importance of initial MTX treatment optimization before initiation of a biological treatment and emphasizes the importance of treat-to-target strategy. Trial registration ClinicalTrials.gov NCT02288520. [ABSTRACT FROM AUTHOR]
- Subjects :
- *RESEARCH
*PATIENT aftercare
*BIOLOGICAL products
*SCIENTIFIC observation
*ORAL drug administration
*FUNCTIONAL status
*MEDICAL cooperation
*METHOTREXATE
*ANTIRHEUMATIC agents
*TREATMENT effectiveness
*RHEUMATOID arthritis
*DISEASE susceptibility
*DESCRIPTIVE statistics
*SYMPTOMS
*DRUG side effects
*LONGITUDINAL method
*PROBABILITY theory
Subjects
Details
- Language :
- English
- ISSN :
- 14620324
- Volume :
- 61
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Rheumatology
- Publication Type :
- Academic Journal
- Accession number :
- 154714013
- Full Text :
- https://doi.org/10.1093/rheumatology/keab274