Comorbidities and chance of remission in patients with early rheumatoid arthritis receiving methotrexate as first-line therapy: a Swedish observational nationwide study
Authors' conclusion
Comorbidities decrease the chance of reaching remission on methotrexate as DMARD monotherapy in patients with early RA and are important to consider when assessing treatment outcomes.
Study context
- Population
- Patients diagnosed with early rheumatoid arthritis (RA) 2007–2020 in Sweden, receiving MTX monotherapy as first disease-modifying antirheumatic drug (DMARD)7,643 with 3-month Disease Activity Score (DAS28)
- Participants
- 11,001 patients
- Exposure
- Patients with vs without each comorbidity category
- Chronic kidney diseasen = 38
- Previous cancern = 319
- Outcome
- Failure to reach DAS28 remission
- Follow-up
- 3 months
Methodological detailsnationwide Swedish clinical and quality registers, modified Poisson regression, RR adjusted for sex and age
- Nationwide Swedish clinical and quality registers
- Modified Poisson regression
- RR adjusted for sex and age
Main finding
As reported in the abstract
Not reaching DAS28 remission on MTX monotherapy, by comorbidity category
RR for not reaching DAS28 remission (adjusted for sex and age) (95% CI)
Endocrine comorbidity
1.08(1.01–1.15)
Gastrointestinal comorbidity
1.16(1.03–1.30)
Infectious comorbidity
1.21(1.06–1.38)
Psychiatric comorbidity
1.24(1.15–1.35)
Respiratory comorbidity
1.16(1.01–1.32)
- ≥3 comorbidity categories: higher risk of DAS28 remission failure at 3 months
- 27%
Observational data: associations, not effects.
Secondary outcomes
Secondary outcomes (Boolean, SDAI/CDAI remission, EULAR response, no swollen joints at 3 and 6 months)
- A similar pattern was observed for the secondary outcomes
Original publication
Comorbidities and chance of remission in patients with early rheumatoid arthritis receiving methotrexate as first-line therapy: a Swedish observational nationwide study. RMD Open. Published 20 December 2023. doi:10.
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