TY - JOUR
T1 - Effect of early treatment on physical function in daily management of rheumatoid arthritis
T2 - A 5-year longitudinal study of rheumatoid arthritis patients in the national database of rheumatic diseases in Japan
AU - Hirata, Akie
AU - Suenaga, Yasuo
AU - Miyamura, Tomoya
AU - Matsui, Toshihiro
AU - Tohma, Shigeto
AU - Suematsu, Eiichi
AU - Ohnaka, Keizo
AU - Takayanagi, Ryoichi
N1 - Funding Information:
The authors are grateful for the assistance of the clinicians who referred patients to NinJa. This work was supported in part by Health Science research grants from the Ministry of Health, Labor, and Welfare of Japan to Shigeto Tohma.
Publisher Copyright:
© 2016 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.
PY - 2018
Y1 - 2018
N2 - Aim: The purpose of this study was to assess 5-year changes in physical function and factors associated with improvement among patients with rheumatoid arthritis (RA) in daily clinical practice, focusing on the effect of treatments, including biologic agents, in the early stage of disease course. Methods: The National Database of Rheumatic Diseases by iR-net in Japan (NinJa) was searched for patients with disease duration ≤ 2 years and modified health assessment questionnaire (mHAQ) > 0 between 2004 and 2007, so that 510 patients were included in the final analysis. Multivariate-logistic regression analyses were used to identify predictors of 5-year mHAQ disability score improvement. Results: Median mHAQ score was 0.40 at baseline and decreased to a median 0.17 after 5 years. Seventy-four percent of the patients were treated with methotrexate (MTX) and 25% with biologic agents, with early use of biologic agents (within 2 years of RA onset) increasing over time. Multivariate analyses identified higher baseline Disease Activity Score of 28 joints – C-reactive protein and early use of MTX (within 1 year of RA onset) and of biologic agents (within 2 years) as significantly associated with improved mHAQ; odds ratios of the early treatment were 1.83 (P = 0.01) for MTX and 2.23 (P = 0.04) for biologic agents, respectively. Conclusion: Five-year mHAQ improved in early RA patients in the NinJa database. In daily clinical management of RA, likewise in clinical trials, early administration of MTX or biologic agents is able to improve physical function outcome.
AB - Aim: The purpose of this study was to assess 5-year changes in physical function and factors associated with improvement among patients with rheumatoid arthritis (RA) in daily clinical practice, focusing on the effect of treatments, including biologic agents, in the early stage of disease course. Methods: The National Database of Rheumatic Diseases by iR-net in Japan (NinJa) was searched for patients with disease duration ≤ 2 years and modified health assessment questionnaire (mHAQ) > 0 between 2004 and 2007, so that 510 patients were included in the final analysis. Multivariate-logistic regression analyses were used to identify predictors of 5-year mHAQ disability score improvement. Results: Median mHAQ score was 0.40 at baseline and decreased to a median 0.17 after 5 years. Seventy-four percent of the patients were treated with methotrexate (MTX) and 25% with biologic agents, with early use of biologic agents (within 2 years of RA onset) increasing over time. Multivariate analyses identified higher baseline Disease Activity Score of 28 joints – C-reactive protein and early use of MTX (within 1 year of RA onset) and of biologic agents (within 2 years) as significantly associated with improved mHAQ; odds ratios of the early treatment were 1.83 (P = 0.01) for MTX and 2.23 (P = 0.04) for biologic agents, respectively. Conclusion: Five-year mHAQ improved in early RA patients in the NinJa database. In daily clinical management of RA, likewise in clinical trials, early administration of MTX or biologic agents is able to improve physical function outcome.
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U2 - 10.1111/1756-185X.12877
DO - 10.1111/1756-185X.12877
M3 - Article
C2 - 27126059
AN - SCOPUS:85047223694
SN - 1756-1841
VL - 21
SP - 828
EP - 835
JO - APLAR Journal of Rheumatology
JF - APLAR Journal of Rheumatology
IS - 4
ER -