Remission in a Prospective Study of Patients With Rheumatoid Arthritis. American Rheumatism Association Preliminary Remission Criteria in Relation to the Disease Activity Score

Prevoo, M.L.L.; Gestel, A.M. van; Hof, M.A. van ‘t; Rijswijk, M.H. van; Putte, L.B.A. van de; Riel, P.L.C.M. van

doi:10.1093/rheumatology/35.11.1101

Cited by 329 publications

(224 citation statements)

References 8 publications

Supporting

Mentioning

208

Contrasting

Unclassified

Order By: Relevance

“…Other secondary end points included improvement from baseline at week 16 in the Disease Activity Score in 28 joints (DAS28) (8)(9)(10), numeric index of the ACR response (ACR-N) (11,12) at week 16, and ACR20, ACR50, and ACR70 responses over time through week 52. HAQ scores were not collected for patients receiving placebo after week 20, when they crossed over to infliximab.…”

Section: Methodsmentioning

confidence: 99%

Golimumab in patients with active rheumatoid arthritis despite treatment with methotrexate: A randomized, double‐blind, placebo‐controlled, dose‐ranging study

Kay

Matteson

Dasgupta³

et al. 2008

Arthritis & Rheumatism

280

167

View full text Add to dashboard Cite

Objective. To assess the efficacy, safety, and pharmacology of subcutaneous administration of golimumab in patients with active rheumatoid arthritis (RA) despite treatment with methotrexate (MTX).Methods. Patients were randomly assigned in a double-blinded manner to receive injections of placebo plus MTX or 50 mg or 100 mg golimumab every 2 or 4 weeks plus MTX through week 48. Patients originally assigned to receive injections every 2 weeks had the interval increased to every 4 weeks starting at week 20. The primary end point was the proportion of patients meeting the American College of Rheumatology 20% improvement criteria (achieving an ACR20 response) at week 16. The study was powered to detect a difference in the primary end point when the combined golimumab groups and at least 1 of the individual dose groups were compared with placebo.Results. The primary end point was attained. Sixty-one percent of patients in the combined golimumab plus MTX dose groups achieved an ACR20 response at week 16 compared with 37% of patients in the placebo plus MTX group (P ‫؍‬ 0.010). In addition, 79% of patients in the group receiving 100 mg golimumab every 2 weeks achieved an ACR20 response (P < 0.001 versus placebo). Through week 20 (after which patients receiving placebo were switched to active infliximab therapy), serious adverse events were reported in 9% of patients in the combined golimumab groups and in 6% of patients in the placebo group.Conclusion. Golimumab plus MTX effectively reduces the signs and symptoms of RA and is generally well tolerated in patients with an inadequate response to MTX.

show abstract

Section: Methodsmentioning

confidence: 99%

Golimumab in patients with active rheumatoid arthritis despite treatment with methotrexate: A randomized, double‐blind, placebo‐controlled, dose‐ranging study

Kay

Matteson

Dasgupta³

et al. 2008

Arthritis & Rheumatism

280

167

View full text Add to dashboard Cite

show abstract

“…An exception to the rule of care-as-usual was made for registration of parameters necessary for calculation of the Disease Activity Score using 28 joints (DAS 28 ), a validated score for establishing disease activity and response to therapy in rheumatoid arthritis [12,13]. The DAS 28 is calculated from four parameters: the number of swollen and tender joints from a total of 28 joints, the erythrocyte sedimentation rate and the visual analogue score for general health as subjectively estimated by the patient.…”

Section: Data Collectionmentioning

confidence: 99%

“…High, moderate or low disease activity is categorized as DAS 28 -scores > 5.1, > 3.2 but £ 5.1 and > 2.6 but £ 3.2, respectively. Remission is categorized as DAS 28 -scores £ 2.6 [12]. Response to treatment according to DAS 28 is defined by both the difference in DAS 28 and the DAS 28 achieved (Table 1).…”

Section: Data Collectionmentioning

confidence: 99%

Leflunomide in active rheumatoid arthritis: a prospective study in daily practice

Roon

Jansen

Mourad

et al. 2004

Brit J Clinical Pharma

View full text Add to dashboard Cite

Aims We prospectively studied the efficacy, incidence of adverse drug reactions and withdrawal from leflunomide in an outpatient population with rheumatoid arthritis in a setting of care‐as‐usual.Methods In this prospective case series study, a standard dataset was collected from outpatient medical records, including patient and disease characteristics, data on leflunomide use and adverse drug reactions.Results During the study period 136 rheumatoid arthritis patients started leflunomide. Median (range) follow‐up duration was 317 (11–911) days. Sixty‐five percent of patients experienced at least one adverse drug reaction related to leflunomide. During follow‐up 76 patients (56%) withdrew from leflunomide treatment, mainly because of adverse drug reactions (29%) or lack of efficacy (13%). The overall incidence density for withdrawal from leflunomide was 56.2 per 100 patient years. Complete data for calculating efficacy using a validated disease activity score on 28 joints (DAS28) was available for 48, 36, and 35% of patients at 2, 6, and 12 months follow‐up, respectively. Within a 12‐month period after start of leflunomide treatment 76% of the evaluable patients were classified as moderate or good responders according to the DAS28 response criteria.Conclusions In the setting of care‐as‐usual rheumatoid arthritis patients starting leflunomide frequently experienced adverse drug reactions. More than half of the patients withdrew from leflunomide treatment within 1 year of starting leflunomide treatment, mainly because of adverse drug reactions.

show abstract

“…Categorization is important for supporting decisions about entry into clinical trials as well as requirements for changes in therapies and for defining therapeutic goals. Such criteria have been proposed for the original DAS (28,29) and the DAS28 (28), but they have not yet been formally established for the SDAI.…”

mentioning

confidence: 99%

Remission and active disease in rheumatoid arthritis: Defining criteria for disease activity states

Aletaha¹,

Ward²,

Machold³

et al. 2005

Arthritis & Rheumatism

475

338

View full text Add to dashboard Cite

Objective. Several composite scores are available to assess the activity of rheumatoid arthritis (RA). Criteria for remission and active RA based on these continuous scores are important for use in clinical practice and clinical trials. We aimed to reevaluate or to define such criteria for the Disease Activity Score in 28 joints (DAS28) and the Simplified Disease Activity Index (SDAI).Methods. We sampled patient profiles from an observational RA database that included clinical and laboratory variables. Thirty-five rheumatology experts classified these profiles into 1 of 4 categories: remission, low, moderate, or high disease activity. Cutoff values were estimated by mapping scores on the DAS28 and SDAI to these ratings, and analyses of agreement (kappa statistics) and a diagnostic testing approach (receiver operating characteristic curves) were used to validate the estimates. The final criteria were validated using 2 observational cohorts (a routine cohort of 767 patients and an inception cohort of 91 patients).Results. Results from the 3 analyses were very similar and were integrated. The criteria for separating remission, low, moderate, and high disease activity based on the SDAI were scores of 3.3, 11, and 26, respectively; those based on the DAS28 were scores of 2.4, 3.6, 5.5, respectively. In the routine cohort, these cutoff values showed substantial agreement (weighed ‫؍‬ 0.70) and discriminated between groups of patients with clearly different functional capacities (P < 0.001). In the inception cohort, these cutoff scores differentiated responders (those with a 20% response on the American College of Rheumatology improvement criteria) from nonresponders (P < 0.01), as well as patients with and without radiologic progression (P < 0.05).Conclusion. New criteria for levels of RA disease activity were determined and internally validated. These criteria, which are based on current and explicit expert judgment, are valuable in this era of rapidly advancing therapeutic approaches.

show abstract

Remission in a Prospective Study of Patients With Rheumatoid Arthritis. American Rheumatism Association Preliminary Remission Criteria in Relation to the Disease Activity Score

Cited by 329 publications

References 8 publications

Golimumab in patients with active rheumatoid arthritis despite treatment with methotrexate: A randomized, double‐blind, placebo‐controlled, dose‐ranging study

Golimumab in patients with active rheumatoid arthritis despite treatment with methotrexate: A randomized, double‐blind, placebo‐controlled, dose‐ranging study

Leflunomide in active rheumatoid arthritis: a prospective study in daily practice

Remission and active disease in rheumatoid arthritis: Defining criteria for disease activity states

Contact Info

Product

Resources

About