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Response to methotrexate predicts long-term patient-related outcomes in rheumatoid arthritis

Dietmar Krause1, Bernadette Gabriel2, Gertraud Herborn3

  • 1Department of Medical Informatics, Biometry and Epidemiology, Ruhr-University, Bochum, Germany. gundi.krause@t-online.de.

Clinical Rheumatology
|February 28, 2016
PubMed

Insights

An early response to methotrexate (MTX) in rheumatoid arthritis (RA) predicts long-term patient-related outcomes (PROs), regardless of continued MTX use. This finding highlights the importance of initial treatment effectiveness in managing RA progression.

Area of Science:

  • Rheumatology
  • Clinical Outcomes Research

Background:

  • Rheumatoid arthritis (RA) management requires understanding factors influencing long-term patient-related outcomes (PROs).
  • Methotrexate (MTX) is a cornerstone therapy for RA, but its long-term impact on PROs needs further elucidation.

Purpose of the Study:

  • To investigate the predictive value of the initial response to methotrexate (MTX) on long-term patient-related outcomes (PROs) in rheumatoid arthritis (RA).
  • To assess whether early MTX efficacy predicts functional status and quality of life in RA patients over 18 years.

Main Methods:

  • Prospective observational study of 271 RA patients initiating MTX between 1980-1987.
  • PROs assessed after an average of 18 years using the International Classification of Functioning, Disability and Health (ICF) framework.
  • Multivariable models analyzed baseline characteristics and MTX response at 1 year as predictors of long-term PROs.

Main Results:

  • A clinical improvement of ≥20% at 1 year post-MTX initiation was associated with favorable long-term PROs across all three ICF dimensions.
  • This association remained significant regardless of continuous MTX use (p < 0.05).
  • Initial MTX response independently predicted long-term PROs in RA patients after 18 years.

Conclusions:

  • The initial response to methotrexate is a crucial independent predictor of long-term patient-related outcomes in rheumatoid arthritis.
  • Early assessment of MTX efficacy can identify patients likely to experience sustained functional benefits.
  • These findings emphasize the significance of early treatment response in RA prognosis.
Keywords:
Long term follow-upMethotrexatePatient outcome assessmentRheumatoid arthritis

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