Predicting Treatment Outcomes with Methotrexate in Early Inflammatory Arthritis
Author Information
Author(s): Hider S L, Silman A J, Thomson W, Lunt M, Bunn D, Symmons D P M
Primary Institution: University of Manchester
Hypothesis
Can clinical factors at presentation be used to predict outcome of treatment with methotrexate in patients with early inflammatory polyarthritis?
Conclusion
Routine clinical and laboratory factors were poor at predicting the outcome of treatment with methotrexate.
Supporting Evidence
- 309 patients were included in the analysis.
- 34 patients stopped for adverse events at 1 year, increasing to 46 at 2 years.
- Shared epitope positivity was the strongest predictor of inefficacy.
- High Health Assessment Questionnaire scores were associated with adverse events.
- 75% of patients remained on methotrexate monotherapy at 1 year.
Takeaway
Doctors tried to figure out who would do well on a medicine called methotrexate for arthritis, but they found it really hard to tell just by looking at patients' symptoms.
Methodology
Patients from the Norfolk Arthritis Register who started methotrexate as their first DMARD within 3 months of diagnosis were analyzed for treatment outcomes over 2 years.
Potential Biases
Potential bias due to non-standardized decision-making by physicians regarding treatment cessation.
Limitations
The study relied on physician opinion for treatment response, lacked detailed clinical data on disease activity and drug dose, and did not include all patients due to specific eligibility criteria.
Participant Demographics
66% female, median age at symptom onset 59.3 years.
Statistical Information
P-Value
0.02
Confidence Interval
95% CI 1.3 to 25.6
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website