Timely escalation to second-line therapies after failure of methotrexate in patients with early rheumatoid arthritis does not reduce the risk of becoming difficult-to-treat
Authors' conclusion
Early implementation of treatment after failure of treat-to-target with MTX may not prevent the development of D2T in RA.
Study context
- Population
- Patients with early rheumatoid arthritis (RA) with first access 2005–2018, treated with initial methotrexate (MTX), starting a b/tsDMARD after failure of treat-to-target with MTXfrom cohort of 722
- Participants
- 155 patients
- Outcome
- Development of D2T RA (EULAR definition and subsequent modifications)
Methodological detailsmultivariable analysis
- Multivariable analysis
Main finding
As reported in the abstract
EULAR D2T criteria fulfilled · median (IQR) follow up 72.6 (34.5-134.2) months
Patients fulfilling EULAR difficult-to-treat (D2T) criteria
45
29%
Observational data: associations, not effects.
Further findings
Retention rates of first and second b/tsDMARD
- Retention after 1 year
- approximatively 70%
- Retention after 5 years
- 40%
Independent predictors of D2T (multivariable analysis)
- Higher number of swollen joints, worse pain scores, shorter disease duration at start of b/tsDMARD, negativity for autoantibodies
Original publication
Timely escalation to second-line therapies after failure of methotrexate in patients with early rheumatoid arthritis does not reduce the risk of becoming difficult-to-treat. Arthritis Res Ther. Published 8 November 2024. doi:10.
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