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Treatment of rheumatoid arthritis with methotrexate alone and in combination with other conventional DMARDs using the T2T strategy. A cohort study

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Abstract

The aim of this study was to evaluate the effect of treatment with methotrexate (MTX), by itself or combined with other non-biological disease-modifying antirheumatic drugs (DMARDs) (methotrexate, MTX with prednisolone, MTX with leflunomide, MTX with chloroquine, and MTX with sulfasalazine) on clinimetric outcomes in a retrospective cohort with a 6-month follow-up and under a Treat to Target (T2T) approach. Patients in treatment with conventional DMARDs and classified as moderate disease activity (MDA) and high disease activity (HDA) were included. Changes in disease activity score (DAS28), health assessment questionnaire (HAQ), tender joint count (TJC), and swollen joint count (SJC) are compared using the Wilcoxon nonparametric test for paired data. Hypothesis contrasts were raised in order to look for differences between the different exposure groups and the outcomes defined by means of the Kruskal–Wallis (KW) nonparametric test. Follow-up was documented in 307 patients, including 250 (81.4 %) women. At the onset, 243 subjects (79.2 %) were classified as MDA and 64 (20.9 %) in HDA. A total of 247 subjects (80.4 %) presented some degree of improvement, with 156 subjects (51 %) entering remission, which is a significant number (p value = 0.047). There were no differences in the level of severity between the treatment groups (p = 0.98). This study, developed in a cohort of patients with RA with moderate or severe disease activity who were treated with MTX by itself or combined with other non-biological DMARDs under T2T strategy, showed a decrease in the severity of disease activity in 80 % of patients. The difference between monotherapy (MTX) and the combinations with other non-biological DMARDs could not be established.

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Acknowledgments

We declare acknowledgments to the following: Juan Bello, MD, Danny Gomez, MD and Vanessa Giraldo, MD, as team members care for these patients. We declare that no funds or grants were received for the realization of this manuscript. The researchers would like to thank the patients who made this project possible.

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Authors and Affiliations

  1. BIOMAB IPS: Rheumatoid Arthritis Center, Carrera 9 N 123-36 segundo piso, Bogotá, Colombia

    Pedro Iván Santos-Moreno, Laura Villarreal & Analhi Palomino

  2. Col-Reuma/LASSERIM-S group, Carrera 19 A # 82-05, Bogotá, Colombia

    José de la Hoz-Valle

  3. SIIES research and education in health, Calle 173 no. 76-70, Bogotá, Colombia

    Guillermo Sánchez & Carlos Castro

Authors
  1. Pedro Iván Santos-Moreno
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  2. José de la Hoz-Valle
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  3. Laura Villarreal
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  5. Guillermo Sánchez
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  6. Carlos Castro
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Correspondence to Pedro Iván Santos-Moreno.

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Santos-Moreno, P.I., de la Hoz-Valle, J., Villarreal, L. et al. Treatment of rheumatoid arthritis with methotrexate alone and in combination with other conventional DMARDs using the T2T strategy. A cohort study. Clin Rheumatol 34, 215–220 (2015). https://doi.org/10.1007/s10067-014-2794-9

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  • DOI: https://doi.org/10.1007/s10067-014-2794-9

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