PMID- 29280011
OWN - NLM
STAT- MEDLINE
DCOM- 20181017
LR  - 20181113
IS  - 1434-9949 (Electronic)
IS  - 0770-3198 (Linking)
VI  - 37
IP  - 6
DP  - 2018 Jun
TI  - High burden of adverse events is associated with reduced remission rates in early
      rheumatoid arthritis.
PG  - 1689-1694
LID - 10.1007/s10067-017-3958-1 [doi]
AB  - Adverse events (AEs) are common during disease-modifying antirheumatic drug
      (DMARD) treatment, but their influence on treatment results is unclear. We
      studied AEs in relation to disease activity in early rheumatoid arthritis (RA).
      Ninety-nine patients started intensive treatment with three conventional
      synthetic DMARDs (csDMARDs) and oral prednisolone, and were randomized to a
      6-month induction treatment with infliximab or placebo. All AEs during the first 
      12 months of treatment were recorded. We scored each AE based on severity (scale 
      1-4) and defined the burden of AEs as the sum of these scores. Patients were
      divided into tertiles according to the burden of AEs. As outcomes, we assessed
      28-joint disease activity score (DAS28) levels and remission rates at 12 and 24
      months. Three hundred thirty-one AEs in 99 patients were reported, and 27 (8%)
      were categorized as severe or serious. Mean burden of AEs per patient was 5.4 +/-
      4.3. Seventy-nine AEs (24%) led to temporary (n = 52) or permanent (n = 27)
      csDMARD discontinuation. Of discontinuations, 1, 21, and 57 were detected in the 
      first, second, and third tertiles, respectively. DAS28 remission rates decreased 
      across tertiles at 12 months (94, 94, and 76%; p for linearity 0.029) and at 24
      months (90, 86, and 70%; p for linearity 0.021). Mean DAS28 levels increased
      across tertiles at 12 months (1.5 +/- 1.0, 1.7 +/- 0.9, and 1.9 +/- 1.2; p for
      linearity 0.021) and at 24 months (1.4 +/- 0.8, 1.6 +/- 1.0, and 1.9 +/- 1.1; p
      for linearity 0.007). High burden of AEs is associated with higher disease
      activity and lower likelihood of remission in early RA.
FAU - Kuusalo, Laura
AU  - Kuusalo L
AUID- ORCID: http://orcid.org/0000-0001-5238-8439
AD  - Department of Internal Medicine, University of Turku and Turku University
      Hospital, Kiinamyllynkatu 4-6, P.O. Box 52, 20521, Turku, Finland.
      laura.kuusalo@utu.fi.
FAU - Puolakka, Kari
AU  - Puolakka K
AD  - South Karelia Central Hospital, Valto Kakelan katu 1, 53130, Lappeenranta,
      Finland.
FAU - Kautiainen, Hannu
AU  - Kautiainen H
AD  - Unit of Primary Health Care, University of Helsinki and Helsinki University
      Hospital, Tukholmankatu 8 B, 00290, Helsinki, Finland.
AD  - Department of General Practice, University of Helsinki, Helsinki, Finland.
AD  - Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland.
FAU - Karjalainen, Anna
AU  - Karjalainen A
AD  - Department of Internal Medicine, University of Oulu and Oulu University Hospital,
      Kajaanintie 50, 90220, Oulu, Finland.
FAU - Malmi, Timo
AU  - Malmi T
AD  - Seinajoki Central Hospital, Hanneksenrinne 7, 60220, Seinajoki, Finland.
FAU - Paimela, Leena
AU  - Paimela L
AD  - ORTON Orthopaedic Hospital, Tenholantie 10, 00280, Helsinki, Finland.
FAU - Leirisalo-Repo, Marjatta
AU  - Leirisalo-Repo M
AD  - Rheumatology, University of Helsinki and Helsinki University Hospital, 00014,
      Helsinki, Finland.
FAU - Rantalaiho, Vappu
AU  - Rantalaiho V
AD  - Department of Internal Medicine, Centre for Rheumatic Diseases, Tampere
      University Hospital, Tampere, Finland.
AD  - Faculty of Medicine and Life Sciences, University of Tampere, Tampereen
      Yliopisto, PL 100, 33014, Tampere, Finland.
CN  - NEO-RACo Study Group
LA  - eng
GR  - 13180/Turun Yliopistosaatio
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
DEP - 20171226
PL  - Germany
TA  - Clin Rheumatol
JT  - Clinical rheumatology
JID - 8211469
RN  - 0 (Antirheumatic Agents)
SB  - IM
MH  - Adult
MH  - Antirheumatic Agents/*adverse effects
MH  - Arthritis, Rheumatoid/*drug therapy
MH  - Drug Therapy, Combination
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Remission Induction
OTO - NOTNLM
OT  - Adverse events
OT  - Clinical trials
OT  - DMARDs
OT  - Remission
OT  - Rheumatoid arthritis
IR  - Alasaarela E
FIR - Alasaarela, Eeva
IR  - Blafield H
FIR - Blafield, Harri
IR  - Eklund KK
FIR - Eklund, Kari K
IR  - Hakola M
FIR - Hakola, Mikko
IR  - Hannonen P
FIR - Hannonen, Pekka
IR  - Ilva K
FIR - Ilva, Kirsti
IR  - Julkunen H
FIR - Julkunen, Heikki
IR  - Kaipiainen-Seppanen O
FIR - Kaipiainen-Seppanen, Oili
IR  - Kauppi M
FIR - Kauppi, Markku
IR  - Kononoff A
FIR - Kononoff, Aulikki
IR  - Krogerus ML
FIR - Krogerus, Maija-Liisa
IR  - Laiho K
FIR - Laiho, Kari
IR  - Luosujarvi R
FIR - Luosujarvi, Riitta
IR  - Luukkainen R
FIR - Luukkainen, Reijo
IR  - Mottonen T
FIR - Mottonen, Timo
IR  - Niinisalo H
FIR - Niinisalo, Helena
IR  - Peltomaa R
FIR - Peltomaa, Ritva
IR  - Pollanen J
FIR - Pollanen, Jari
IR  - Uusitalo T
FIR - Uusitalo, Tea
IR  - Uutela T
FIR - Uutela, Toini
IR  - Valleala H
FIR - Valleala, Heikki
IR  - Vuori K
FIR - Vuori, Kaisa
IR  - Laasonen L
FIR - Laasonen, Leena
IR  - Moilanen E
FIR - Moilanen, Eeva
IR  - Nieminen R
FIR - Nieminen, Riina
IR  - Vuolteenaho K
FIR - Vuolteenaho, Katriina
EDAT- 2017/12/28 06:00
MHDA- 2018/10/18 06:00
CRDT- 2017/12/28 06:00
PHST- 2017/09/25 00:00 [received]
PHST- 2017/12/14 00:00 [accepted]
PHST- 2017/12/09 00:00 [revised]
PHST- 2017/12/28 06:00 [pubmed]
PHST- 2018/10/18 06:00 [medline]
PHST- 2017/12/28 06:00 [entrez]
AID - 10.1007/s10067-017-3958-1 [doi]
AID - 10.1007/s10067-017-3958-1 [pii]
PST - ppublish
SO  - Clin Rheumatol. 2018 Jun;37(6):1689-1694. doi: 10.1007/s10067-017-3958-1. Epub
      2017 Dec 26.