Hand-dominant joint involvement pattern associates with favourable, and polyarthritis with unfavourable, treatment response to both conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and biological disease-modifying antirheumatic drugs (bDMARDs) in early rheumatoid arthritis: a combined analysis of NOrdic Rheumatic Diseases Strategy Trials And Registries (NORD-STAR) and Behandel-Strategieën (BeSt) trials
Authors' conclusion
In early RA, csDMARD and bDMARD treatments resulted in the greatest improvement in disease activity in JIP-Hand and the least improvement in JIP-Poly.
Study context
- Population
- Treatment-naïve patients with early rheumatoid arthritis (RA) in the NORD-STAR and BeSt RCTs
- Participants
- 1,250 patients2 RCTs
- Comparison
- Joint involvement pattern (JIP) subgroups (JIP-Hand, JIP-Poly) and other clinical predictors in relation to treatment response to csDMARDs and bDMARDs
- Outcome
- Longitudinal CDAI
- Follow-up
- Through week 48
Methodological detailsNORD-STAR and BeSt, mixed-model analysis, longitudinal
- NORD-STAR and BeSt
- Mixed-model analysis
- Longitudinal
Pooled result
As reported in the abstract
CDAI after treatment (mixed model)
Beta
−1.4
95% CI −2.3 to −0.55P = 0.0016
JIP-Hand · significantly better Clinical Disease Activity Index (CDAI) scores
Beta
0.95
95% CI 0.064–1.8P = 0.035
JIP-Poly · worse outcomes
Further pooled results
| Outcome | Beta (95% CI) | P value |
|---|---|---|
| Female sex and CDAI scores · through week 48Associated with worse CDAI scores · mixed-model analysis | 1.2 (0.40–2.0) | P = 0.0031 |
| Anticitrullinated protein antibodies and CDAI scores · through week 48Mixed-model analysis | 0.19 (−0.69 to 1.1) | P = 0.67 |
csDMARDs vs combined bDMARDs within JIP subgroups
- csDMARDs and combined bDMARDs similarly effective in the respective JIP subgroups
- interaction p > .10
Original publication
Hand-dominant joint involvement pattern associates with favourable, and polyarthritis with unfavourable, treatment response to both csDMARDs and bDMARDs in early rheumatoid arthritis: a combined analysis of NORD-STAR and BeSt trials. Ann Rheum Dis. Published 8 March 2026. doi:10.
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