0000000000621304
AUTHOR
Alain Saraux
Choice of second-line disease-modifying antirheumatic drugs after failure of methotrexate therapy for rheumatoid arthritis: A decision tree for clinical practice based on rheumatologists' preferences
Objective To survey rheumatologists' preferences for the choice of a second-line disease-modifying antirheumatic drug (DMARD) after inadequate response with methotrexate (MTX) therapy in rheumatoid arthritis (RA). Methods Thirty-six rheumatologists stated their preferences for RA treatment after inadequate response with MTX therapy (optimal dose at least 6 months). From the initial scenario, we derived 54 vignettes varying by rheumatoid factor or anti–cyclic citrullinated peptide antibody presence, swollen joint count, Disease Activity Score in 28 joints, and structural damage. Respondents stated their preference among 5 therapeutic options: MTX continuation, switch to another conventional …
Clinical practice format for choosing a second-line disease modifying anti-rheumatic drug in early rheumatoid arthritis after failure of 6 months' first-line DMARD therapy.
International audience; BACKGROUND: The objective was to develop a clinical practice format for choosing a second-line disease-modifying anti-rheumatic drug (DMARD) after a 6-month course of a first-line DMARD in patients with early RA. METHODS: A panel of 34 experts selected treatment option from various scenarios using the Thurstone pairwise method. The experts had to choose between two proposed DMARDs without proposing other options. The scenarios were obtained using the three items: DAS28, rheumatoid factor status and radiographic structural damage. A sample of 240 among 480 scenarios for each expert was taken at random. Responses given by at least 20% of the experts were considered per…
Perception des poussées de polyarthrite rhumatoïde telles que rapportées par les patients : sous-analyse de l’essai STRASS sur les stratégies de diminution progressive du traitement
Resume Objectifs Dans la polyarthrite rhumatoide (PR), patients et medecins peuvent avoir des perceptions differentes. L’objectif de ce travail etait de definir la notion de « poussees » du point de vue du patient. Methodes Analyse post-hoc d’un essai comparatif randomise consacre a une strategie de diminution progressive des anti-TNF chez des patients atteints de PR, ayant un score DAS 28 de remission depuis au moins six mois et randomises dans deux groupes : « espacement » (E) ou « maintien » (M) du traitement. La survenue de poussees rapportees par le patient (PRP) a ete evaluee tous les trois mois sur une periode de 18 mois par la question suivante : « Au cours des trois derniers mois, …