Are switches from oral to subcutaneous methotrexate or addition of ciclosporin to methotrexate useful steps in a tight control treatment strategy for rheumatoid arthritis? A post hoc analysis of the CAMERA study
Objective To investigate the effects of a switch from oral methotrexate (MTX) to subcutaneous MTX (scMTX) or adding ciclosporin to oral MTX with a simultaneous reduction of the MTX dose, in case of adverse events (AE) or insufficient effect (IE) in rheumatoid arthritis (RA). Methods The tight contro...
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| Veröffentlicht in: | Annals of the rheumatic diseases 2010-10, Vol.69 (10), p.1849-1852 |
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| container_title | Annals of the rheumatic diseases |
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| creator | Bakker, M F Jacobs, J W G Welsing, P M J van der Werf, J H Linn-Rasker, S P van der Veen, M J Lafeber, F P J G Bijlsma, J W J |
| description | Objective To investigate the effects of a switch from oral methotrexate (MTX) to subcutaneous MTX (scMTX) or adding ciclosporin to oral MTX with a simultaneous reduction of the MTX dose, in case of adverse events (AE) or insufficient effect (IE) in rheumatoid arthritis (RA). Methods The tight control treatment arm of the Computer Assisted Management in Early RA (CAMERA) trial was evaluated. The change in 28-joint Disease Activity Score (DAS28) after taking scMTX (over 1 month) or adding ciclosporin (over 3 months) was compared to the average monthly change in the preceding 3 months. Analyses were performed separately for strategy steps because of AE or IE. Results Of 151 patients, 57 needed the scMTX strategy step (21 because of AE, 36 because of IE) and 40 the following ciclosporin strategy step (20 and 20, respectively). The decrease in DAS28 after taking the scMTX strategy step was 0.30 points (p |
| doi_str_mv | 10.1136/ard.2009.124065 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_755398415</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>755398415</sourcerecordid><originalsourceid>FETCH-LOGICAL-b493t-e0f3bfa709cc00d8dfa496965ec7f525a3558b3d9fa2515b1022083d4cc23cd33</originalsourceid><addsrcrecordid>eNqFkUuLFDEUhYMozti6dicBEUGonjwq9VhJ20zPiKPC-NiGVCqZSltVaXNTOP07_UOmqXZEN65CuN85NzkHoaeULCnlxZkK7ZIRUi8py0kh7qFTmhdVxkhB7qNTQgjP8rooT9AjgG26kopWD9EJI4LSgpJT9HMVDIYfLurOALbBD9gH1ePoMUyNnqIajZ8ADyZ2PgZzq6JJBFZt66LzI_YWa6d7Dzsf3HjQ_YVOYOzUY4hmBzjNFY7upotY-zEGn_YEo-JgxpiQkAQ3e2yTfejMNKjoXYtViF1Iu-A1XuGdh4g7r7EaVb8HB4f9sTN4vXp_fr1KJlO7f4weWNWDeXI8F-jL5vzz-jK7-njxdr26ypq85jEzxPLGqpLUWhPSVq1VKau6EEaXVjChuBBVw9vaKiaoaChhjFS8zbVmXLecL9DL2XcX_PfJQJSDA236fs5MlkLwusqpSOTzf8itn0L6AkhalmUl6oofqLOZ0sEDBGPlLrhBhb2kRB7qlqlueahbznUnxbOj79QMpr3jf_ebgBdHQIFWvQ1q1A7-cJwVIk9pLFA2cy41dXs3V-GbLEpeCvnh61pes827zZvLT_Ii8a9mvhm2_33lL8dL09A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1777859835</pqid></control><display><type>article</type><title>Are switches from oral to subcutaneous methotrexate or addition of ciclosporin to methotrexate useful steps in a tight control treatment strategy for rheumatoid arthritis? A post hoc analysis of the CAMERA study</title><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><creator>Bakker, M F ; Jacobs, J W G ; Welsing, P M J ; van der Werf, J H ; Linn-Rasker, S P ; van der Veen, M J ; Lafeber, F P J G ; Bijlsma, J W J</creator><creatorcontrib>Bakker, M F ; Jacobs, J W G ; Welsing, P M J ; van der Werf, J H ; Linn-Rasker, S P ; van der Veen, M J ; Lafeber, F P J G ; Bijlsma, J W J ; Utrecht Arthritis Cohort Study Group</creatorcontrib><description>Objective To investigate the effects of a switch from oral methotrexate (MTX) to subcutaneous MTX (scMTX) or adding ciclosporin to oral MTX with a simultaneous reduction of the MTX dose, in case of adverse events (AE) or insufficient effect (IE) in rheumatoid arthritis (RA). Methods The tight control treatment arm of the Computer Assisted Management in Early RA (CAMERA) trial was evaluated. The change in 28-joint Disease Activity Score (DAS28) after taking scMTX (over 1 month) or adding ciclosporin (over 3 months) was compared to the average monthly change in the preceding 3 months. Analyses were performed separately for strategy steps because of AE or IE. Results Of 151 patients, 57 needed the scMTX strategy step (21 because of AE, 36 because of IE) and 40 the following ciclosporin strategy step (20 and 20, respectively). The decrease in DAS28 after taking the scMTX strategy step was 0.30 points (p<0.05); no significant change in DAS28 was seen after the ciclosporin strategy step. In both strategy steps for AE or IE, quite similar observations were made. Of the patients who took the scMTX strategy step, 63% showed improvement. Conclusion scMTX seems a useful treatment step after oral MTX in a tight control strategy, whereas the ciclosporin step seems ineffective.</description><identifier>ISSN: 0003-4967</identifier><identifier>EISSN: 1468-2060</identifier><identifier>DOI: 10.1136/ard.2009.124065</identifier><identifier>PMID: 20511610</identifier><identifier>CODEN: ARDIAO</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and European League Against Rheumatism</publisher><subject>Administration, Oral ; Adult ; Aged ; Antirheumatic Agents - administration & dosage ; Antirheumatic Agents - adverse effects ; Antirheumatic Agents - therapeutic use ; Arthritis, Rheumatoid - drug therapy ; Biological and medical sciences ; Bones, joints and connective tissue. Antiinflammatory agents ; Cameras ; Cyclosporine - adverse effects ; Cyclosporine - therapeutic use ; Diseases of the osteoarticular system ; Drug Therapy, Combination ; Female ; Humans ; Inflammatory joint diseases ; Injections, Subcutaneous ; Male ; Medical sciences ; Methotrexate ; Methotrexate - administration & dosage ; Methotrexate - adverse effects ; Methotrexate - therapeutic use ; Middle Aged ; Pharmacology. Drug treatments ; Prospective Studies ; Rheumatoid arthritis ; Severity of Illness Index ; Studies ; Treatment Outcome</subject><ispartof>Annals of the rheumatic diseases, 2010-10, Vol.69 (10), p.1849-1852</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>2015 INIST-CNRS</rights><rights>Copyright: 2010 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b493t-e0f3bfa709cc00d8dfa496965ec7f525a3558b3d9fa2515b1022083d4cc23cd33</citedby><cites>FETCH-LOGICAL-b493t-e0f3bfa709cc00d8dfa496965ec7f525a3558b3d9fa2515b1022083d4cc23cd33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://ard.bmj.com/content/69/10/1849.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://ard.bmj.com/content/69/10/1849.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,776,780,3182,23551,27903,27904,77346,77377</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23265449$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20511610$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bakker, M F</creatorcontrib><creatorcontrib>Jacobs, J W G</creatorcontrib><creatorcontrib>Welsing, P M J</creatorcontrib><creatorcontrib>van der Werf, J H</creatorcontrib><creatorcontrib>Linn-Rasker, S P</creatorcontrib><creatorcontrib>van der Veen, M J</creatorcontrib><creatorcontrib>Lafeber, F P J G</creatorcontrib><creatorcontrib>Bijlsma, J W J</creatorcontrib><creatorcontrib>Utrecht Arthritis Cohort Study Group</creatorcontrib><title>Are switches from oral to subcutaneous methotrexate or addition of ciclosporin to methotrexate useful steps in a tight control treatment strategy for rheumatoid arthritis? A post hoc analysis of the CAMERA study</title><title>Annals of the rheumatic diseases</title><addtitle>Ann Rheum Dis</addtitle><description>Objective To investigate the effects of a switch from oral methotrexate (MTX) to subcutaneous MTX (scMTX) or adding ciclosporin to oral MTX with a simultaneous reduction of the MTX dose, in case of adverse events (AE) or insufficient effect (IE) in rheumatoid arthritis (RA). Methods The tight control treatment arm of the Computer Assisted Management in Early RA (CAMERA) trial was evaluated. The change in 28-joint Disease Activity Score (DAS28) after taking scMTX (over 1 month) or adding ciclosporin (over 3 months) was compared to the average monthly change in the preceding 3 months. Analyses were performed separately for strategy steps because of AE or IE. Results Of 151 patients, 57 needed the scMTX strategy step (21 because of AE, 36 because of IE) and 40 the following ciclosporin strategy step (20 and 20, respectively). The decrease in DAS28 after taking the scMTX strategy step was 0.30 points (p<0.05); no significant change in DAS28 was seen after the ciclosporin strategy step. In both strategy steps for AE or IE, quite similar observations were made. Of the patients who took the scMTX strategy step, 63% showed improvement. Conclusion scMTX seems a useful treatment step after oral MTX in a tight control strategy, whereas the ciclosporin step seems ineffective.</description><subject>Administration, Oral</subject><subject>Adult</subject><subject>Aged</subject><subject>Antirheumatic Agents - administration & dosage</subject><subject>Antirheumatic Agents - adverse effects</subject><subject>Antirheumatic Agents - therapeutic use</subject><subject>Arthritis, Rheumatoid - drug therapy</subject><subject>Biological and medical sciences</subject><subject>Bones, joints and connective tissue. Antiinflammatory agents</subject><subject>Cameras</subject><subject>Cyclosporine - adverse effects</subject><subject>Cyclosporine - therapeutic use</subject><subject>Diseases of the osteoarticular system</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Humans</subject><subject>Inflammatory joint diseases</subject><subject>Injections, Subcutaneous</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Methotrexate</subject><subject>Methotrexate - administration & dosage</subject><subject>Methotrexate - adverse effects</subject><subject>Methotrexate - therapeutic use</subject><subject>Middle Aged</subject><subject>Pharmacology. Drug treatments</subject><subject>Prospective Studies</subject><subject>Rheumatoid arthritis</subject><subject>Severity of Illness Index</subject><subject>Studies</subject><subject>Treatment Outcome</subject><issn>0003-4967</issn><issn>1468-2060</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkUuLFDEUhYMozti6dicBEUGonjwq9VhJ20zPiKPC-NiGVCqZSltVaXNTOP07_UOmqXZEN65CuN85NzkHoaeULCnlxZkK7ZIRUi8py0kh7qFTmhdVxkhB7qNTQgjP8rooT9AjgG26kopWD9EJI4LSgpJT9HMVDIYfLurOALbBD9gH1ePoMUyNnqIajZ8ADyZ2PgZzq6JJBFZt66LzI_YWa6d7Dzsf3HjQ_YVOYOzUY4hmBzjNFY7upotY-zEGn_YEo-JgxpiQkAQ3e2yTfejMNKjoXYtViF1Iu-A1XuGdh4g7r7EaVb8HB4f9sTN4vXp_fr1KJlO7f4weWNWDeXI8F-jL5vzz-jK7-njxdr26ypq85jEzxPLGqpLUWhPSVq1VKau6EEaXVjChuBBVw9vaKiaoaChhjFS8zbVmXLecL9DL2XcX_PfJQJSDA236fs5MlkLwusqpSOTzf8itn0L6AkhalmUl6oofqLOZ0sEDBGPlLrhBhb2kRB7qlqlueahbznUnxbOj79QMpr3jf_ebgBdHQIFWvQ1q1A7-cJwVIk9pLFA2cy41dXs3V-GbLEpeCvnh61pes827zZvLT_Ii8a9mvhm2_33lL8dL09A</recordid><startdate>20101001</startdate><enddate>20101001</enddate><creator>Bakker, M F</creator><creator>Jacobs, J W G</creator><creator>Welsing, P M J</creator><creator>van der Werf, J H</creator><creator>Linn-Rasker, S P</creator><creator>van der Veen, M J</creator><creator>Lafeber, F P J G</creator><creator>Bijlsma, J W J</creator><general>BMJ Publishing Group Ltd and European League Against Rheumatism</general><general>BMJ Publishing Group</general><general>Elsevier Limited</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>LK8</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20101001</creationdate><title>Are switches from oral to subcutaneous methotrexate or addition of ciclosporin to methotrexate useful steps in a tight control treatment strategy for rheumatoid arthritis? A post hoc analysis of the CAMERA study</title><author>Bakker, M F ; Jacobs, J W G ; Welsing, P M J ; van der Werf, J H ; Linn-Rasker, S P ; van der Veen, M J ; Lafeber, F P J G ; Bijlsma, J W J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b493t-e0f3bfa709cc00d8dfa496965ec7f525a3558b3d9fa2515b1022083d4cc23cd33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Administration, Oral</topic><topic>Adult</topic><topic>Aged</topic><topic>Antirheumatic Agents - administration & dosage</topic><topic>Antirheumatic Agents - adverse effects</topic><topic>Antirheumatic Agents - therapeutic use</topic><topic>Arthritis, Rheumatoid - drug therapy</topic><topic>Biological and medical sciences</topic><topic>Bones, joints and connective tissue. Antiinflammatory agents</topic><topic>Cameras</topic><topic>Cyclosporine - adverse effects</topic><topic>Cyclosporine - therapeutic use</topic><topic>Diseases of the osteoarticular system</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Humans</topic><topic>Inflammatory joint diseases</topic><topic>Injections, Subcutaneous</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Methotrexate</topic><topic>Methotrexate - administration & dosage</topic><topic>Methotrexate - adverse effects</topic><topic>Methotrexate - therapeutic use</topic><topic>Middle Aged</topic><topic>Pharmacology. Drug treatments</topic><topic>Prospective Studies</topic><topic>Rheumatoid arthritis</topic><topic>Severity of Illness Index</topic><topic>Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bakker, M F</creatorcontrib><creatorcontrib>Jacobs, J W G</creatorcontrib><creatorcontrib>Welsing, P M J</creatorcontrib><creatorcontrib>van der Werf, J H</creatorcontrib><creatorcontrib>Linn-Rasker, S P</creatorcontrib><creatorcontrib>van der Veen, M J</creatorcontrib><creatorcontrib>Lafeber, F P J G</creatorcontrib><creatorcontrib>Bijlsma, J W J</creatorcontrib><creatorcontrib>Utrecht Arthritis Cohort Study Group</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of the rheumatic diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bakker, M F</au><au>Jacobs, J W G</au><au>Welsing, P M J</au><au>van der Werf, J H</au><au>Linn-Rasker, S P</au><au>van der Veen, M J</au><au>Lafeber, F P J G</au><au>Bijlsma, J W J</au><aucorp>Utrecht Arthritis Cohort Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Are switches from oral to subcutaneous methotrexate or addition of ciclosporin to methotrexate useful steps in a tight control treatment strategy for rheumatoid arthritis? A post hoc analysis of the CAMERA study</atitle><jtitle>Annals of the rheumatic diseases</jtitle><addtitle>Ann Rheum Dis</addtitle><date>2010-10-01</date><risdate>2010</risdate><volume>69</volume><issue>10</issue><spage>1849</spage><epage>1852</epage><pages>1849-1852</pages><issn>0003-4967</issn><eissn>1468-2060</eissn><coden>ARDIAO</coden><abstract>Objective To investigate the effects of a switch from oral methotrexate (MTX) to subcutaneous MTX (scMTX) or adding ciclosporin to oral MTX with a simultaneous reduction of the MTX dose, in case of adverse events (AE) or insufficient effect (IE) in rheumatoid arthritis (RA). Methods The tight control treatment arm of the Computer Assisted Management in Early RA (CAMERA) trial was evaluated. The change in 28-joint Disease Activity Score (DAS28) after taking scMTX (over 1 month) or adding ciclosporin (over 3 months) was compared to the average monthly change in the preceding 3 months. Analyses were performed separately for strategy steps because of AE or IE. Results Of 151 patients, 57 needed the scMTX strategy step (21 because of AE, 36 because of IE) and 40 the following ciclosporin strategy step (20 and 20, respectively). The decrease in DAS28 after taking the scMTX strategy step was 0.30 points (p<0.05); no significant change in DAS28 was seen after the ciclosporin strategy step. In both strategy steps for AE or IE, quite similar observations were made. Of the patients who took the scMTX strategy step, 63% showed improvement. Conclusion scMTX seems a useful treatment step after oral MTX in a tight control strategy, whereas the ciclosporin step seems ineffective.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and European League Against Rheumatism</pub><pmid>20511610</pmid><doi>10.1136/ard.2009.124065</doi><tpages>4</tpages></addata></record> |
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| ispartof | Annals of the rheumatic diseases, 2010-10, Vol.69 (10), p.1849-1852 |
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| subjects | Administration, Oral Adult Aged Antirheumatic Agents - administration & dosage Antirheumatic Agents - adverse effects Antirheumatic Agents - therapeutic use Arthritis, Rheumatoid - drug therapy Biological and medical sciences Bones, joints and connective tissue. Antiinflammatory agents Cameras Cyclosporine - adverse effects Cyclosporine - therapeutic use Diseases of the osteoarticular system Drug Therapy, Combination Female Humans Inflammatory joint diseases Injections, Subcutaneous Male Medical sciences Methotrexate Methotrexate - administration & dosage Methotrexate - adverse effects Methotrexate - therapeutic use Middle Aged Pharmacology. Drug treatments Prospective Studies Rheumatoid arthritis Severity of Illness Index Studies Treatment Outcome |
| title | Are switches from oral to subcutaneous methotrexate or addition of ciclosporin to methotrexate useful steps in a tight control treatment strategy for rheumatoid arthritis? A post hoc analysis of the CAMERA study |
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