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Baseline Laboratory Test Abnormalities are Common in Early Arthritis but Rarely Contraindicate Methotrexate: Study of Three Cohorts (ESPOIR, VErA, and Brittany)
- Source :
- Seminars in Arthritis and Rheumatism, Seminars in Arthritis and Rheumatism, WB Saunders, 2013, epub ahead of print. ⟨10.1016/j.semarthrit.2012.08.001⟩
- Publication Year :
- 2013
- Publisher :
- Elsevier BV, 2013.
-
Abstract
- International audience; OBJECTIVE: To evaluate the prevalence of baseline abnormalities in standard laboratory tests in patients with early arthritis and their impact on selection of disease-modifying antirheumatic drugs according to American College of Rheumatology (ACR) recommendations and/or of nonsteroidal anti-inflammatory drugs. METHODS: In three cohorts of patients with early arthritis (the ESPOIR, VErA, and Brittany cohorts), we evaluated the prevalence of anemia (hemoglobinN or>2N), and systemic inflammation (erythrocyte sedimentation rate [ESR]>20 and C-reactive protein [CRP]>6). RESULTS: We evaluated 1393 patients (1018 women and 375 men). Anemia was present in 363/1366 (26.5%) patients, leukopenia in 18/1372 (1.3%), and thrombocytopenia in 13/1371 (0.9%). ESR elevation was seen in 50.4% of patients and CRP elevation in 62.7%. The level of AST was above normal in 4% and of ALT in 10% of patients. No patient had severe renal dysfunction, 5.6% had moderate renal dysfunction, and 42.6% had mild renal dysfunction. Among the 1094 patients who had undergone all the tests, only 18 (1.64%, 95% confidence interval, 1-2.64) had a formal contraindication to methotrexate therapy according to ACR recommendations (4 had leukopenia, 12 had high ALT levels, and 2 had high ALT and AST levels). CONCLUSION: Patients with recent-onset arthritis often have anemia, mild or moderate renal dysfunction, and abnormal liver function. However, fewer than 2% have laboratory test abnormalities contraindicating methotrexate therapy.
- Subjects :
- Male
medicine.medical_specialty
Anemia
Renal function
Arthritis
Gastroenterology
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Liver Function Tests
Rheumatology
Internal medicine
medicine
Humans
Aspartate Aminotransferases
Renal Insufficiency
030212 general & internal medicine
Contraindication
030203 arthritis & rheumatology
Leukopenia
medicine.diagnostic_test
Diagnostic Tests, Routine
business.industry
Contraindications
Liver Diseases
Alanine Transaminase
medicine.disease
Thrombocytopenia
Systemic Inflammatory Response Syndrome
3. Good health
Early Diagnosis
Methotrexate
Anesthesiology and Pain Medicine
Antirheumatic Agents
Rheumatoid arthritis
Erythrocyte sedimentation rate
Immunology
Female
medicine.symptom
business
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Subjects
Details
- ISSN :
- 00490172
- Volume :
- 42
- Database :
- OpenAIRE
- Journal :
- Seminars in Arthritis and Rheumatism
- Accession number :
- edsair.doi.dedup.....865cc890fc4cbf349b4b6960ecf5698c