Farragher, TM orcid.org/0000-0002-1968-6378, Lunt, M, Fu, B et al. (2 more authors) (2010) Early treatment with, and time receiving, first disease-modifying antirheumatic drug predicts long-term function in patients with inflammatory polyarthritis. Annals of the Rheumatic Diseases, 69 (4). pp. 689-695. ISSN 0003-4967
Abstract
Objectives
To investigate the influence of early disease-modifying antirheumatic drug (DMARD) treatment on long-term functional outcome in patients with recent-onset inflammatory polyarthritis (IP), and the impact of the duration of first and subsequent DMARD treatment.
Methods
642 subjects from a primary care registry of patients with new-onset IP, recruited 1990–4, were followed up for 10 years. Mean change in Health Assessment Questionnaire (HAQ) scores between baseline and 10 years were compared by time to, and time receiving, first DMARD treatment and total time receiving treatment, using linear regression. Adjustment for time-dependent confounders and censoring was performed using marginal structural weights.
Results
When adjusted for baseline and subsequent disease severity, those treated early (<6 months from symptom onset) experienced a non-significant improvement in function compared with those never treated (adjusted mean difference in change (adj_MDIC) in HAQ −0.24; 95% CI −0.58 to 0.09); and a significant benefit for each additional month of treatment within 6 months of the onset of symptoms (adj_MDIC −0.10; 95% CI −0.19 to −0.02). Patients who discontinued their first DMARD within 6 months experienced a significant deterioration in long-term function (adj_MDIC in HAQ 0.28; 95% CI 0.04 to 0.52), while those who continued their first treatment for > 3 years experienced an improvement (adj_MDIC in HAQ −0.37; 95% CI −0.77 to 0.04).
Conclusions
The importance of time to, and response to, first DMARD treatment and total duration of DMARD treatment in modifying the 10-year function in patients with IP has been demonstrated.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This paper is freely available online under the BMJ Journals unlocked scheme, see http://ard.bmj.com/info/unlocked.dtl |
Keywords: | RHEUMATOID-ARTHRITIS PATIENTS; HEALTH-ASSESSMENT QUESTIONNAIRE; SURVIVAL ANALYSIS; PROPENSITY SCORE; CLINICAL-TRIALS; DISABILITY; MODELS; LIMITATIONS; COMMUNITY; SELECTION |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 11 Jul 2019 13:04 |
Last Modified: | 11 Jul 2019 13:04 |
Status: | Published |
Publisher: | BMJ Publishing Group |
Identification Number: | 10.1136/ard.2009.108639 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:105359 |