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Treatment discontinuation in patients with very early rheumatoid arthritis in sustained simplified disease activity index remission after synthetic disease-modifying anti-rheumatic drug administration
We aimed to identify whether drug-free remission could be achieved in patients with very early rheumatoid arthritis (RA) with poor prognosis factors by treatment with synthetic disease-modifying antirheumatic drugs (DMARDs). Thirteen patients with very early RA, whose disease was considered to have...
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| Published in: | Modern rheumatology 2012-06, Vol.22 (3), p.346-352 |
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| Main Authors: | , , , , , , , , , , , , , , , , |
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| container_end_page | 352 |
| container_issue | 3 |
| container_start_page | 346 |
| container_title | Modern rheumatology |
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| creator | Kita, Junko Tamai, Mami Arima, Kazuhiko Nakashima, Yoshikazu Suzuki, Takahisa Kawashiri, Shin-ya Iwamoto, Naoki Okada, Akitomo Koga, Tomohiro Yamasaki, Satoshi Nakamura, Hideki Origuchi, Tomoki Ida, Hiroaki Aoyagi, Kiyoshi Uetani, Masataka Eguchi, Katsumi Kawakami, Atsushi |
| description | We aimed to identify whether drug-free remission could be achieved in patients with very early rheumatoid arthritis (RA) with poor prognosis factors by treatment with synthetic disease-modifying antirheumatic drugs (DMARDs). Thirteen patients with very early RA, whose disease was considered to have highly erosive potential, were included. Magnetic resonance imaging (MRI)-proven bone edema and autoantibodies were determined in these patients. A treat-to-target strategy initiated with synthetic DMARDs was employed for 12 months. If the patients achieved simplified disease activity index (SDAI) remission along with a reduction of the RA MRI scoring bone edema score to |
| doi_str_mv | 10.1007/s10165-011-0522-8 |
| format | article |
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Thirteen patients with very early RA, whose disease was considered to have highly erosive potential, were included. Magnetic resonance imaging (MRI)-proven bone edema and autoantibodies were determined in these patients. A treat-to-target strategy initiated with synthetic DMARDs was employed for 12 months. If the patients achieved simplified disease activity index (SDAI) remission along with a reduction of the RA MRI scoring bone edema score to <33% as compared with baseline at 12 months, DMARD treatment was stopped and the clinical status was further observed for the following 12 months. Synthetic DMARDs were stopped at 12 months in 5 patients. One of the 5 was lost to follow-up because of sustaining an injury that required orthopedic surgery. Three of the remaining 4 patients showed continued SDAI remission that was DMARD-free without any evidence of radiographic progression for the following 12 months. Although this was a small clinical trial, we have shown–for the first time–that true remission of very early RA with poor prognosis factors can be achieved by treatment with synthetic DMARDs.</description><identifier>ISSN: 1439-7595</identifier><identifier>EISSN: 1439-7609</identifier><identifier>DOI: 10.1007/s10165-011-0522-8</identifier><identifier>PMID: 21960457</identifier><language>eng</language><publisher>Japan: Springer Japan</publisher><subject>Aged ; Antirheumatic Agents - therapeutic use ; Arthritis, Rheumatoid - diagnostic imaging ; Arthritis, Rheumatoid - drug therapy ; Arthrography ; Clinical outcomes ; Disease Progression ; Drug therapy ; Female ; Glucocorticoids - therapeutic use ; Humans ; Male ; Medicine ; Medicine & Public Health ; Methotrexate - therapeutic use ; Middle Aged ; Original Article ; Orthopedics ; Remission Induction ; Rheumatoid arthritis ; Rheumatology ; Severity of Illness Index ; Treatment Outcome ; Withholding Treatment</subject><ispartof>Modern rheumatology, 2012-06, Vol.22 (3), p.346-352</ispartof><rights>Japan College of Rheumatology 2011</rights><rights>Japan College of Rheumatology 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c383t-705dd11108cd581c3f850770b9dd086f8b181e7daf5d0ede3b5aa27fd91716cb3</citedby><cites>FETCH-LOGICAL-c383t-705dd11108cd581c3f850770b9dd086f8b181e7daf5d0ede3b5aa27fd91716cb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21960457$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kita, Junko</creatorcontrib><creatorcontrib>Tamai, Mami</creatorcontrib><creatorcontrib>Arima, Kazuhiko</creatorcontrib><creatorcontrib>Nakashima, Yoshikazu</creatorcontrib><creatorcontrib>Suzuki, Takahisa</creatorcontrib><creatorcontrib>Kawashiri, Shin-ya</creatorcontrib><creatorcontrib>Iwamoto, Naoki</creatorcontrib><creatorcontrib>Okada, Akitomo</creatorcontrib><creatorcontrib>Koga, Tomohiro</creatorcontrib><creatorcontrib>Yamasaki, Satoshi</creatorcontrib><creatorcontrib>Nakamura, Hideki</creatorcontrib><creatorcontrib>Origuchi, Tomoki</creatorcontrib><creatorcontrib>Ida, Hiroaki</creatorcontrib><creatorcontrib>Aoyagi, Kiyoshi</creatorcontrib><creatorcontrib>Uetani, Masataka</creatorcontrib><creatorcontrib>Eguchi, Katsumi</creatorcontrib><creatorcontrib>Kawakami, Atsushi</creatorcontrib><title>Treatment discontinuation in patients with very early rheumatoid arthritis in sustained simplified disease activity index remission after synthetic disease-modifying anti-rheumatic drug administration</title><title>Modern rheumatology</title><addtitle>Mod Rheumatol</addtitle><addtitle>Mod Rheumatol</addtitle><description>We aimed to identify whether drug-free remission could be achieved in patients with very early rheumatoid arthritis (RA) with poor prognosis factors by treatment with synthetic disease-modifying antirheumatic drugs (DMARDs). Thirteen patients with very early RA, whose disease was considered to have highly erosive potential, were included. Magnetic resonance imaging (MRI)-proven bone edema and autoantibodies were determined in these patients. A treat-to-target strategy initiated with synthetic DMARDs was employed for 12 months. If the patients achieved simplified disease activity index (SDAI) remission along with a reduction of the RA MRI scoring bone edema score to <33% as compared with baseline at 12 months, DMARD treatment was stopped and the clinical status was further observed for the following 12 months. Synthetic DMARDs were stopped at 12 months in 5 patients. One of the 5 was lost to follow-up because of sustaining an injury that required orthopedic surgery. Three of the remaining 4 patients showed continued SDAI remission that was DMARD-free without any evidence of radiographic progression for the following 12 months. Although this was a small clinical trial, we have shown–for the first time–that true remission of very early RA with poor prognosis factors can be achieved by treatment with synthetic DMARDs.</description><subject>Aged</subject><subject>Antirheumatic Agents - therapeutic use</subject><subject>Arthritis, Rheumatoid - diagnostic imaging</subject><subject>Arthritis, Rheumatoid - drug therapy</subject><subject>Arthrography</subject><subject>Clinical outcomes</subject><subject>Disease Progression</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Glucocorticoids - therapeutic use</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Methotrexate - therapeutic use</subject><subject>Middle Aged</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Remission Induction</subject><subject>Rheumatoid arthritis</subject><subject>Rheumatology</subject><subject>Severity of Illness Index</subject><subject>Treatment Outcome</subject><subject>Withholding Treatment</subject><issn>1439-7595</issn><issn>1439-7609</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><recordid>eNpdks9u1DAQxiMEoqXwAFyQJS5cDONkHdtHVPFPqsSlnC0nnnSnSpzFdgp5Qx4Lp7srIU7-5PnNN2P5q6rXAt4LAPUhCRCt5CAEB1nXXD-pLsWuMVy1YJ6etTTyonqR0j1AI402z6uLWpgWdlJdVn9uI7o8YcjMU-rnkCksLtMcGAV2KKqUEvtFec8eMK4MXRxXFve4TC7P5JmLeR8pU9oa0pKyo4CeJZoOIw1UZDFGl5C5PtMD5bWAHn-ziBOltE1yQ8bI0hryHjP15wY-zZ6GlcIdc2Uvfhq6AXEpd36iQCnHx3VfVs8GNyZ8dTqvqh-fP91ef-U33798u_54w_tGN5krkN4LIUD3XmrRN4OWoBR0xnvQ7aA7oQUq7wbpAT02nXSuVoM3Qom275qr6t3R9xDnnwumbMsrehxHF3BekhVQg66N0lDQt_-h9_MSQ9nukZIg9U4V6s2JWroJvT1Emlxc7fmPClAfgVRK4Q7jvzZ2C4I9BsGWINgtCFY3fwHeFqq6</recordid><startdate>20120601</startdate><enddate>20120601</enddate><creator>Kita, Junko</creator><creator>Tamai, Mami</creator><creator>Arima, Kazuhiko</creator><creator>Nakashima, Yoshikazu</creator><creator>Suzuki, Takahisa</creator><creator>Kawashiri, Shin-ya</creator><creator>Iwamoto, Naoki</creator><creator>Okada, Akitomo</creator><creator>Koga, Tomohiro</creator><creator>Yamasaki, Satoshi</creator><creator>Nakamura, Hideki</creator><creator>Origuchi, Tomoki</creator><creator>Ida, Hiroaki</creator><creator>Aoyagi, Kiyoshi</creator><creator>Uetani, Masataka</creator><creator>Eguchi, Katsumi</creator><creator>Kawakami, Atsushi</creator><general>Springer Japan</general><general>Informa Healthcare</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PADUT</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20120601</creationdate><title>Treatment discontinuation in patients with very early rheumatoid arthritis in sustained simplified disease activity index remission after synthetic disease-modifying anti-rheumatic drug administration</title><author>Kita, Junko ; Tamai, Mami ; Arima, Kazuhiko ; Nakashima, Yoshikazu ; Suzuki, Takahisa ; Kawashiri, Shin-ya ; Iwamoto, Naoki ; Okada, Akitomo ; Koga, Tomohiro ; Yamasaki, Satoshi ; Nakamura, Hideki ; Origuchi, Tomoki ; Ida, Hiroaki ; Aoyagi, Kiyoshi ; Uetani, Masataka ; Eguchi, Katsumi ; Kawakami, Atsushi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c383t-705dd11108cd581c3f850770b9dd086f8b181e7daf5d0ede3b5aa27fd91716cb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Aged</topic><topic>Antirheumatic Agents - 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Academic</collection><jtitle>Modern rheumatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kita, Junko</au><au>Tamai, Mami</au><au>Arima, Kazuhiko</au><au>Nakashima, Yoshikazu</au><au>Suzuki, Takahisa</au><au>Kawashiri, Shin-ya</au><au>Iwamoto, Naoki</au><au>Okada, Akitomo</au><au>Koga, Tomohiro</au><au>Yamasaki, Satoshi</au><au>Nakamura, Hideki</au><au>Origuchi, Tomoki</au><au>Ida, Hiroaki</au><au>Aoyagi, Kiyoshi</au><au>Uetani, Masataka</au><au>Eguchi, Katsumi</au><au>Kawakami, Atsushi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment discontinuation in patients with very early rheumatoid arthritis in sustained simplified disease activity index remission after synthetic disease-modifying anti-rheumatic drug administration</atitle><jtitle>Modern rheumatology</jtitle><stitle>Mod Rheumatol</stitle><addtitle>Mod Rheumatol</addtitle><date>2012-06-01</date><risdate>2012</risdate><volume>22</volume><issue>3</issue><spage>346</spage><epage>352</epage><pages>346-352</pages><issn>1439-7595</issn><eissn>1439-7609</eissn><abstract>We aimed to identify whether drug-free remission could be achieved in patients with very early rheumatoid arthritis (RA) with poor prognosis factors by treatment with synthetic disease-modifying antirheumatic drugs (DMARDs). Thirteen patients with very early RA, whose disease was considered to have highly erosive potential, were included. Magnetic resonance imaging (MRI)-proven bone edema and autoantibodies were determined in these patients. A treat-to-target strategy initiated with synthetic DMARDs was employed for 12 months. If the patients achieved simplified disease activity index (SDAI) remission along with a reduction of the RA MRI scoring bone edema score to <33% as compared with baseline at 12 months, DMARD treatment was stopped and the clinical status was further observed for the following 12 months. Synthetic DMARDs were stopped at 12 months in 5 patients. One of the 5 was lost to follow-up because of sustaining an injury that required orthopedic surgery. Three of the remaining 4 patients showed continued SDAI remission that was DMARD-free without any evidence of radiographic progression for the following 12 months. Although this was a small clinical trial, we have shown–for the first time–that true remission of very early RA with poor prognosis factors can be achieved by treatment with synthetic DMARDs.</abstract><cop>Japan</cop><pub>Springer Japan</pub><pmid>21960457</pmid><doi>10.1007/s10165-011-0522-8</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Antirheumatic Agents - therapeutic use Arthritis, Rheumatoid - diagnostic imaging Arthritis, Rheumatoid - drug therapy Arthrography Clinical outcomes Disease Progression Drug therapy Female Glucocorticoids - therapeutic use Humans Male Medicine Medicine & Public Health Methotrexate - therapeutic use Middle Aged Original Article Orthopedics Remission Induction Rheumatoid arthritis Rheumatology Severity of Illness Index Treatment Outcome Withholding Treatment |
| title | Treatment discontinuation in patients with very early rheumatoid arthritis in sustained simplified disease activity index remission after synthetic disease-modifying anti-rheumatic drug administration |
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