PMID- 19581281
OWN - NLM
STAT- MEDLINE
DCOM- 20100716
LR  - 20161125
IS  - 1468-2060 (Electronic)
IS  - 0003-4967 (Linking)
VI  - 69
IP  - 6
DP  - 2010 Jun
TI  - Adverse events and factors associated with toxicity in patients with early 
      rheumatoid arthritis treated with methotrexate tight control therapy: the CAMERA 
      study.
PG  - 1044-8
LID - 10.1136/ard.2008.106617 [doi]
AB  - OBJECTIVE: To evaluate toxicity profiles in patients with rheumatoid arthritis 
      (RA) treated either according to an intensive or a conventional treatment 
      strategy approach with methotrexate (MTX) and to study factors associated with 
      MTX-related toxicity. METHODS: Data were used from the Computer-Assisted 
      Management in Early Rheumatoid Arthritis (CAMERA) study, in which clinical 
      efficacy of an intensive treatment strategy with MTX was more beneficial than a 
      conventional treatment strategy approach. In this study, data on adverse events 
      (AEs) were compared between the two strategy groups. Logistic regression analyses 
      were used to identify possible associations between factors assessed at baseline 
      and withdrawal due to MTX-related AEs or liver toxicity at follow-up. RESULTS: 
      Although significantly more patients in the intensive strategy group experienced 
      MTX-related AEs than in the conventional strategy group, all recorded AEs were 
      relatively mild. A higher body mass index (BMI) was significantly associated with 
      withdrawal due to MTX-related AEs in the multiple regression analyses (odds 
      ratio=1.207, 95% confidence interval 1.02 to 1.44, p=0.033). There was a trend 
      towards an association between diminished creatinine clearance and MTX 
      withdrawal. For liver toxicity, increased serum liver enzymes at baseline were 
      associated with liver toxicity during follow-up. CONCLUSION: Although the 
      occurrence of AEs in the intensive strategy group was higher than in the 
      conventional strategy group, the previously observed clinical efficacy of an 
      intensive treatment strategy seems to outweigh the observed toxicity profiles. 
      When starting MTX, attention should be given to patients with a high BMI and 
      those with increased levels of liver enzymes and decreased renal function.
FAU - Verstappen, S M M
AU  - Verstappen SM
AD  - University Medical Center Utrecht, Department of Rheumatology and Clinical 
      Immunology, F02.127, PO Box 85500, 3508 GA Utrecht, The Netherlands.
FAU - Bakker, M F
AU  - Bakker MF
FAU - Heurkens, A H M
AU  - Heurkens AH
FAU - van der Veen, M J
AU  - van der Veen MJ
FAU - Kruize, A A
AU  - Kruize AA
FAU - Geurts, M A W
AU  - Geurts MA
FAU - Bijlsma, J W J
AU  - Bijlsma JW
FAU - Jacobs, J W G
AU  - Jacobs JW
CN  - Utrecht Rheumatoid Arthritis Cohort Study Group
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
DEP - 20090705
PL  - England
TA  - Ann Rheum Dis
JT  - Annals of the rheumatic diseases
JID - 0372355
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Immunosuppressive Agents)
RN  - YL5FZ2Y5U1 (Methotrexate)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antirheumatic Agents/administration & dosage/*adverse effects
MH  - Arthritis, Rheumatoid/*drug therapy
MH  - Chemical and Drug Induced Liver Injury/etiology
MH  - Drug Administration Schedule
MH  - Drug Therapy, Computer-Assisted/methods
MH  - Epidemiologic Methods
MH  - Female
MH  - Humans
MH  - Immunosuppressive Agents/administration & dosage/*adverse effects
MH  - Male
MH  - Methotrexate/administration & dosage/*adverse effects
MH  - Middle Aged
EDAT- 2009/07/08 09:00
MHDA- 2010/07/17 06:00
CRDT- 2009/07/08 09:00
PHST- 2009/07/08 09:00 [entrez]
PHST- 2009/07/08 09:00 [pubmed]
PHST- 2010/07/17 06:00 [medline]
AID - ard.2008.106617 [pii]
AID - 10.1136/ard.2008.106617 [doi]
PST - ppublish
SO  - Ann Rheum Dis. 2010 Jun;69(6):1044-8. doi: 10.1136/ard.2008.106617. Epub 2009 Jul 
      5.