PMID- 28450312
OWN - NLM
STAT- MEDLINE
DCOM- 20170821
LR  - 20170821
IS  - 1468-2060 (Electronic)
IS  - 0003-4967 (Linking)
VI  - 76
IP  - 8
DP  - 2017 Aug
TI  - Long-term outcome is better when a methotrexate-based treatment strategy is 
      combined with 10 mg prednisone daily: follow-up after the second 
      Computer-Assisted Management in Early Rheumatoid Arthritis trial.
PG  - 1432-1435
LID - 10.1136/annrheumdis-2016-210647 [doi]
AB  - OBJECTIVES: In the second Computer-Assisted Management in Early Rheumatoid 
      Arthritis trial, patients had started with methotrexate and 10 mg prednisone 
      (MTX+pred) or placebo (MTX+plac). After the trial, prednisone was tapered and 
      stopped, if possible. The objective was to compare, during the post-trial 
      follow-up between the two former strategy groups, initiation of the first 
      biological disease-modifying antirheumatic drug (bDMARD), radiographic outcome 
      and onset of glucocorticoid (GC)-related comorbidities. METHODS: Data on 
      prednisone and bDMARD use and onset of GC-related comorbidities were collected 
      retrospectively. Sharp/van der Heijde scoring was performed. Data were analysed 
      using Fisher's exact and Mann-Whitney U tests. RESULTS: Of 218 patients 
      post-trial follow-up data were available. The maximum follow-up time was 11.8 
      years. Fewer patients initiated a first bDMARD in the former MTX+pred compared 
      with the former MTX+plac strategy group: 31% vs 50%, p=0.003. At the 2 year 
      post-trial follow-up, the median erosion score was significantly lower in the 
      former MTX+pred versus former MTX+plac strategy group: 0 (range 0-0) versus 0 
      (0-2), p=0.002. No significant differences between the former strategy groups in 
      the onset of GC-related comorbidities during the post-trial follow-up were found. 
      CONCLUSION: Addition of 10 mg prednisone daily to an MTX-based treatment strategy 
      in early rheumatoid arthritis results in a lower initiation rate of a first 
      bDMARD and significantly better radiographic outcomes, yet does not result in 
      more GC-related comorbidities.
CI  - (c) Article author(s) (or their employer(s) unless otherwise stated in the text of 
      the article) 2017. All rights reserved. No commercial use is permitted unless 
      otherwise expressly granted.
FAU - Safy, M
AU  - Safy M
AD  - Department of Rheumatology and Clinical Immunology, University Medical Center 
      Utrecht, Utrecht, The Netherlands.
FAU - Jacobs, Jwg
AU  - Jacobs J
AD  - Department of Rheumatology and Clinical Immunology, University Medical Center 
      Utrecht, Utrecht, The Netherlands.
FAU - IJff, N D
AU  - IJff ND
AD  - Department of Rheumatology and Clinical Immunology, University Medical Center 
      Utrecht, Utrecht, The Netherlands.
FAU - Bijlsma, Jwj
AU  - Bijlsma J
AD  - Department of Rheumatology and Clinical Immunology, University Medical Center 
      Utrecht, Utrecht, The Netherlands.
FAU - van Laar, J M
AU  - van Laar JM
AD  - Department of Rheumatology and Clinical Immunology, University Medical Center 
      Utrecht, Utrecht, The Netherlands.
FAU - de Hair, Mjh
AU  - de Hair M
AD  - Department of Rheumatology and Clinical Immunology, University Medical Center 
      Utrecht, Utrecht, The Netherlands.
CN  - Society for Rheumatology Research Utrecht (SRU)
LA  - eng
PT  - Journal Article
DEP - 20170427
PL  - England
TA  - Ann Rheum Dis
JT  - Annals of the rheumatic diseases
JID - 0372355
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Glucocorticoids)
RN  - VB0R961HZT (Prednisone)
RN  - YL5FZ2Y5U1 (Methotrexate)
SB  - IM
CIN - Ann Rheum Dis. 2018 Aug;77(8):e47. PMID: 28939632
CIN - Ann Rheum Dis. 2018 Aug;77(8):e48. PMID: 28993345
MH  - Adult
MH  - Aged
MH  - Antirheumatic Agents/*therapeutic use
MH  - Arthritis, Rheumatoid/*drug therapy
MH  - Drug Therapy, Combination
MH  - Drug Therapy, Computer-Assisted
MH  - Early Medical Intervention
MH  - Female
MH  - Follow-Up Studies
MH  - Glucocorticoids/*therapeutic use
MH  - Humans
MH  - Male
MH  - Methotrexate/*therapeutic use
MH  - Middle Aged
MH  - Prednisone/*therapeutic use
MH  - Randomized Controlled Trials as Topic
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - biologicals
OT  - glucocorticoids
OT  - outcome
OT  - rheumatoid arthritis
COIS- Competing interests: JMvL received honoraria from MSD, Roche, Pfizer, BMS, Eli 
      Lilly. JWJB received honoraria from AbbVie, BMS, MSD, Pfizer, Roche, SUN, UCB. MS 
      was supported by a research grant from Astra Zeneca. Astra Zeneca was not 
      involved in this study.
EDAT- 2017/04/30 06:00
MHDA- 2017/08/22 06:00
CRDT- 2017/04/29 06:00
PHST- 2016/10/06 00:00 [received]
PHST- 2017/04/04 00:00 [revised]
PHST- 2017/04/09 00:00 [accepted]
PHST- 2017/04/30 06:00 [pubmed]
PHST- 2017/08/22 06:00 [medline]
PHST- 2017/04/29 06:00 [entrez]
AID - annrheumdis-2016-210647 [pii]
AID - 10.1136/annrheumdis-2016-210647 [doi]
PST - ppublish
SO  - Ann Rheum Dis. 2017 Aug;76(8):1432-1435. doi: 10.1136/annrheumdis-2016-210647. 
      Epub 2017 Apr 27.