The long-term impact of early treatment of rheumatoid arthritis on radiographic progression: a population-based cohort study

被引:88
|
作者
Kyburz, Diego [1 ]
Gabay, Cem [2 ]
Michel, Beat A. [1 ]
Finckh, Axel [2 ]
机构
[1] Univ Zurich Hosp, Dept Rheumatol, CH-8091 Zurich, Switzerland
[2] Univ Hosp Geneva, Div Rheumatol, Geneva, Switzerland
[3] SCQM Fdn, Zurich, Switzerland
基金
瑞士国家科学基金会;
关键词
Rheumatoid arthritis; Anti-rheumatic therapy; Radiographic progression; Disease-modifying anti-rheumatic drug; Cohort; Swiss clinical quality management in rheumatoid arthritis; Therapeutic window; MODIFYING ANTIRHEUMATIC DRUGS; 5-YEAR FOLLOW-UP; COMBINATION THERAPY; DELAYED TREATMENT; JOINT DAMAGE;
D O I
10.1093/rheumatology/keq424
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective. To measure the long-term rate of radiographic progression in a cohort of patients treated early vs late with conventional DMARDs. Methods. The long-term rate of radiographic progression in patients included in the Swiss clinical quality management in rheumatoid arthritis (SCQM-RA) registry who initiated treatment with conventional DMARDs within the first year of symptom onset (early DMARD) vs patients who initiated treatment 1-5 years after symptom onset (late DMARD). Radiographic progression was assessed in 38 joints using a validated score (Ratingen Score). The rate of progression was calculated using a multivariate regression model for longitudinal data, adjusting for potential confounders. Results. A total of 970 RA patients were included. The 368 patients in the early DMARD group started therapy after a median symptom duration of 6 months, whereas the 602 patients in the late DMARD group initiated therapy after median 2.5 years. RF, MTX use and other risk factors for erosive disease progression were similar between the two groups. However, the estimated rate of radiographic progression at baseline was higher in the early DMARD vs the late DMARD group (1.8 vs 0.6, P < 0.01). In spite of this, the long-term rate of radiographic progression was significantly lower in the early DMARD group after adjustment for confounding factors (-0.35 at 5 years, P = 0.012). Conclusion. This result supports the concept of a therapeutic window of opportunity early in the disease course and suggests that early initiation of DMARD therapy results in a long-lasting reduction of radiographic damage.
引用
收藏
页码:1106 / 1110
页数:5
相关论文
共 50 条
  • [1] Long-term impact of early treatment on radiographic progression in rheumatoid arthritis: A meta-analysis
    Finckh, Axel
    Liang, Matthew H.
    van Herckenrode, Carmen Mugica
    de Pablo, Paola
    ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH, 2006, 55 (06): : 864 - 872
  • [2] The long-term impact of early aggressive treatment of rheumatoid arthritis on radiographic progression: A meta-analysis.
    Finckh, A
    van Herckenrode, CM
    Liang, MH
    de Pablo, P
    ARTHRITIS AND RHEUMATISM, 2004, 50 (09): : S403 - S403
  • [3] Long-Term Alcohol Intake and Risk of Rheumatoid Arthritis in Women: A Population-Based Cohort Study
    Lunzer, R.
    JOURNAL FUR MINERALSTOFFWECHSEL, 2012, 19 (04): : 197 - +
  • [4] Smoking Impact on Radiographic Progression in An Early Rheumatoid Arthritis Cohort
    Ruiz-Esquide, Virginia
    Gomez Puerta, Jose Alfredo
    Cabrera, S.
    Canete, J. D.
    Hernandez, M. V.
    Graell, Eduard
    Ercilla, Guadalupe
    Vinas, Odette
    Gomara, M. J.
    Haro, Isabel
    Sanmarti, Raimon
    ARTHRITIS AND RHEUMATISM, 2011, 63 (10): : S831 - S832
  • [5] The long-term impact of early treatment of rheumatoid arthritis
    Finckh, A.
    Gabay, C.
    Kyburz, D.
    SWISS MEDICAL WEEKLY, 2009, 139 (31-32) : 2S - 2S
  • [6] LONG-TERM RADIOGRAPHIC PROGRESSION IN TREATED RHEUMATOID-ARTHRITIS
    VANDERHEIJDE, DM
    VANRIEL, PL
    VANDEPUTTE, LB
    BRITISH JOURNAL OF RHEUMATOLOGY, 1990, 29 (05): : 404 - 404
  • [7] Radiographic progression in rheumatoid arthritis - A long-term prospective study of 109 patients
    Graudal, NA
    Jurik, AG
    de Carvalho, A
    Graudal, HK
    ARTHRITIS AND RHEUMATISM, 1998, 41 (08): : 1470 - 1480
  • [8] REMISSION AND RADIOGRAPHIC PROGRESSION IN RHEUMATOID ARTHRITIS: REVIEW OF REGISTRY DATA AND LONG-TERM COHORT STUDIES
    Peterson, S.
    Ganguly, R.
    Van Laer, J.
    Atanasov, P.
    Li, N.
    VALUE IN HEALTH, 2017, 20 (05) : A141 - A141
  • [9] The ACPA isotype profile reflects long-term radiographic progression in rheumatoid arthritis
    van der Woude, Diane
    Syversen, Silje W.
    van der Voort, Ellen I. H.
    Verpoort, Kirsten N.
    Goll, Guro L.
    van der Linden, Michael P. M.
    van der Helm-van Mil, Annette H. M.
    van der Heijde, Desiree M. F. M.
    Huizinga, Tom W. J.
    Kvien, Tore K.
    Toes, Rene E. M.
    ANNALS OF THE RHEUMATIC DISEASES, 2010, 69 (06) : 1110 - 1116
  • [10] Impact of Rheumatoid Arthritis on Alopecia: A Nationwide Population-Based Cohort Study in Taiwan
    Chang, Yi-Jung
    Lee, Yung-Heng
    Leong, Pui-Ying
    Wang, Yu-Hsun
    Wei, James Cheng-Chung
    FRONTIERS IN MEDICINE, 2020, 7