Remaining Pain in Early Rheumatoid Arthritis Patients Treated With Methotrexate
Objective To investigate the frequency of remaining pain in early rheumatoid arthritis (RA) after 3 months of treatment with methotrexate as the only disease modifying antirheumatic drug, with a special focus on patients with a good clinical response. Methods The study base was cases reported to a p...
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| Veröffentlicht in: | Arthritis care & research (2010) 2016-08, Vol.68 (8), p.1061-1068 |
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| creator | Altawil, Reem Saevarsdottir, Saedis Wedrén, Sara Alfredsson, Lars Klareskog, Lars Lampa, Jon |
| description | Objective
To investigate the frequency of remaining pain in early rheumatoid arthritis (RA) after 3 months of treatment with methotrexate as the only disease modifying antirheumatic drug, with a special focus on patients with a good clinical response.
Methods
The study base was cases reported to a population‐based early RA cohort who had followup data from the Swedish Rheumatology Quality Register (n = 1,241). The Disease Activity Score in 28 joints European League Against Rheumatism (EULAR) response criteria were used to evaluate clinical response to treatment as good, moderate, and no response. The primary end point was remaining pain at the 3‐months followup visit, defined as pain >20 mm on a 100‐mm visual analog scale (VAS).
Results
Remaining pain in spite of a EULAR good response at followup was associated with higher baseline disability, using the Health Assessment Questionnaire (adjusted odds ratio [OR] 2.2 [95% confidence interval (95% CI) 1.4–3.4] per unit increase), and less baseline inflammation, using the erythrocyte sedimentation rate (adjusted OR 0.81 [95% CI 0.70–0.93] per 10‐mm increase). Similar associations were detected for remaining pain at followup in spite of low inflammatory activity, defined as a C‐reactive protein level |
| doi_str_mv | 10.1002/acr.22790 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_507925</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1811901792</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4860-a99b48fd8b197adc855e6245db941097b8a9d9dc3367c451ea50ee16b0df60dd3</originalsourceid><addsrcrecordid>eNqNkc1KLDEQhYMoKurCF5Be6qI1SSfdyUYYhtF7QVEGRXch3amxo_2jSUbvvP2N9jjoQjAEqqj66iTFQWif4GOCMT3RlTumtJB4DW1TwknKci7WVzm730J73j_ieDIqRCY30RbNC8EyKbbR1RRabTvbPSTXMSbxTrRrFsm0hnmrQ29NMnKhdjZYH5FgoQs-uXGgA5jkzoY6uYRQ98HBv1jaRRsz3XjYW8YddHs2uRn_SS-uzv-ORxdpxUSOUy1lycTMiJLIQptKcA45ZdyUkhEsi1JoaaSpsiwvKsYJaI4BSF5iM8uxMdkOSgdd_wbP81I9O9tqt1C9tmpZeooZKI4LSXnkTwc-dlowVdzC6ebb2PdOZ2v10L8qTqjkhYgCh0sB17_MwQfVWl9B0-gO-rlXRBAiMYmP_QLFOWMsK3BEjwa0cr33DmarHxGs3u1V0V71YW9kD76usCI_zYzAyQC82QYWPyup0Xg6SP4HjwGwMA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1806444370</pqid></control><display><type>article</type><title>Remaining Pain in Early Rheumatoid Arthritis Patients Treated With Methotrexate</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>SWEPUB Freely available online</source><creator>Altawil, Reem ; Saevarsdottir, Saedis ; Wedrén, Sara ; Alfredsson, Lars ; Klareskog, Lars ; Lampa, Jon</creator><creatorcontrib>Altawil, Reem ; Saevarsdottir, Saedis ; Wedrén, Sara ; Alfredsson, Lars ; Klareskog, Lars ; Lampa, Jon</creatorcontrib><description>Objective
To investigate the frequency of remaining pain in early rheumatoid arthritis (RA) after 3 months of treatment with methotrexate as the only disease modifying antirheumatic drug, with a special focus on patients with a good clinical response.
Methods
The study base was cases reported to a population‐based early RA cohort who had followup data from the Swedish Rheumatology Quality Register (n = 1,241). The Disease Activity Score in 28 joints European League Against Rheumatism (EULAR) response criteria were used to evaluate clinical response to treatment as good, moderate, and no response. The primary end point was remaining pain at the 3‐months followup visit, defined as pain >20 mm on a 100‐mm visual analog scale (VAS).
Results
Remaining pain in spite of a EULAR good response at followup was associated with higher baseline disability, using the Health Assessment Questionnaire (adjusted odds ratio [OR] 2.2 [95% confidence interval (95% CI) 1.4–3.4] per unit increase), and less baseline inflammation, using the erythrocyte sedimentation rate (adjusted OR 0.81 [95% CI 0.70–0.93] per 10‐mm increase). Similar associations were detected for remaining pain at followup in spite of low inflammatory activity, defined as a C‐reactive protein level <10. Increase in VAS pain during the treatment period was observed in 19% of the whole cohort, with frequencies in the EULAR response groups of 9% (good response), 15% (moderate response), and 45% (no response).
Conclusion
These results are in line with the hypothesis that a subgroup of early RA patients exhibits pain that is not inflammatory mediated, where alternative treatment strategies to traditional antiinflammatory medications need to be considered.</description><identifier>ISSN: 2151-464X</identifier><identifier>EISSN: 2151-4658</identifier><identifier>DOI: 10.1002/acr.22790</identifier><identifier>PMID: 26784398</identifier><language>eng</language><publisher>United States: John Wiley and Sons Inc</publisher><subject>Adult ; Antirheumatic Agents - therapeutic use ; Arthritis, Rheumatoid - complications ; Arthritis, Rheumatoid - drug therapy ; Case-Control Studies ; Female ; Humans ; Male ; Methotrexate - therapeutic use ; Middle Aged ; Odds Ratio ; Pain - epidemiology ; Pain - etiology ; Pain Measurement ; Rheumatoid Arthritis ; Sweden - epidemiology ; Treatment Outcome</subject><ispartof>Arthritis care & research (2010), 2016-08, Vol.68 (8), p.1061-1068</ispartof><rights>2016 The Authors. Arthritis Care & Research published by Wiley Periodicals, Inc. on behalf of the American College of Rheumatology.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4860-a99b48fd8b197adc855e6245db941097b8a9d9dc3367c451ea50ee16b0df60dd3</citedby><cites>FETCH-LOGICAL-c4860-a99b48fd8b197adc855e6245db941097b8a9d9dc3367c451ea50ee16b0df60dd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Facr.22790$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Facr.22790$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,550,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26784398$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:134167651$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Altawil, Reem</creatorcontrib><creatorcontrib>Saevarsdottir, Saedis</creatorcontrib><creatorcontrib>Wedrén, Sara</creatorcontrib><creatorcontrib>Alfredsson, Lars</creatorcontrib><creatorcontrib>Klareskog, Lars</creatorcontrib><creatorcontrib>Lampa, Jon</creatorcontrib><title>Remaining Pain in Early Rheumatoid Arthritis Patients Treated With Methotrexate</title><title>Arthritis care & research (2010)</title><addtitle>Arthritis Care Res (Hoboken)</addtitle><description>Objective
To investigate the frequency of remaining pain in early rheumatoid arthritis (RA) after 3 months of treatment with methotrexate as the only disease modifying antirheumatic drug, with a special focus on patients with a good clinical response.
Methods
The study base was cases reported to a population‐based early RA cohort who had followup data from the Swedish Rheumatology Quality Register (n = 1,241). The Disease Activity Score in 28 joints European League Against Rheumatism (EULAR) response criteria were used to evaluate clinical response to treatment as good, moderate, and no response. The primary end point was remaining pain at the 3‐months followup visit, defined as pain >20 mm on a 100‐mm visual analog scale (VAS).
Results
Remaining pain in spite of a EULAR good response at followup was associated with higher baseline disability, using the Health Assessment Questionnaire (adjusted odds ratio [OR] 2.2 [95% confidence interval (95% CI) 1.4–3.4] per unit increase), and less baseline inflammation, using the erythrocyte sedimentation rate (adjusted OR 0.81 [95% CI 0.70–0.93] per 10‐mm increase). Similar associations were detected for remaining pain at followup in spite of low inflammatory activity, defined as a C‐reactive protein level <10. Increase in VAS pain during the treatment period was observed in 19% of the whole cohort, with frequencies in the EULAR response groups of 9% (good response), 15% (moderate response), and 45% (no response).
Conclusion
These results are in line with the hypothesis that a subgroup of early RA patients exhibits pain that is not inflammatory mediated, where alternative treatment strategies to traditional antiinflammatory medications need to be considered.</description><subject>Adult</subject><subject>Antirheumatic Agents - therapeutic use</subject><subject>Arthritis, Rheumatoid - complications</subject><subject>Arthritis, Rheumatoid - drug therapy</subject><subject>Case-Control Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Methotrexate - therapeutic use</subject><subject>Middle Aged</subject><subject>Odds Ratio</subject><subject>Pain - epidemiology</subject><subject>Pain - etiology</subject><subject>Pain Measurement</subject><subject>Rheumatoid Arthritis</subject><subject>Sweden - epidemiology</subject><subject>Treatment Outcome</subject><issn>2151-464X</issn><issn>2151-4658</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><sourceid>D8T</sourceid><recordid>eNqNkc1KLDEQhYMoKurCF5Be6qI1SSfdyUYYhtF7QVEGRXch3amxo_2jSUbvvP2N9jjoQjAEqqj66iTFQWif4GOCMT3RlTumtJB4DW1TwknKci7WVzm730J73j_ieDIqRCY30RbNC8EyKbbR1RRabTvbPSTXMSbxTrRrFsm0hnmrQ29NMnKhdjZYH5FgoQs-uXGgA5jkzoY6uYRQ98HBv1jaRRsz3XjYW8YddHs2uRn_SS-uzv-ORxdpxUSOUy1lycTMiJLIQptKcA45ZdyUkhEsi1JoaaSpsiwvKsYJaI4BSF5iM8uxMdkOSgdd_wbP81I9O9tqt1C9tmpZeooZKI4LSXnkTwc-dlowVdzC6ebb2PdOZ2v10L8qTqjkhYgCh0sB17_MwQfVWl9B0-gO-rlXRBAiMYmP_QLFOWMsK3BEjwa0cr33DmarHxGs3u1V0V71YW9kD76usCI_zYzAyQC82QYWPyup0Xg6SP4HjwGwMA</recordid><startdate>201608</startdate><enddate>201608</enddate><creator>Altawil, Reem</creator><creator>Saevarsdottir, Saedis</creator><creator>Wedrén, Sara</creator><creator>Alfredsson, Lars</creator><creator>Klareskog, Lars</creator><creator>Lampa, Jon</creator><general>John Wiley and Sons Inc</general><scope>24P</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>7X8</scope><scope>7QP</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>ZZAVC</scope></search><sort><creationdate>201608</creationdate><title>Remaining Pain in Early Rheumatoid Arthritis Patients Treated With Methotrexate</title><author>Altawil, Reem ; Saevarsdottir, Saedis ; Wedrén, Sara ; Alfredsson, Lars ; Klareskog, Lars ; Lampa, Jon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4860-a99b48fd8b197adc855e6245db941097b8a9d9dc3367c451ea50ee16b0df60dd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Antirheumatic Agents - therapeutic use</topic><topic>Arthritis, Rheumatoid - complications</topic><topic>Arthritis, Rheumatoid - drug therapy</topic><topic>Case-Control Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Methotrexate - therapeutic use</topic><topic>Middle Aged</topic><topic>Odds Ratio</topic><topic>Pain - epidemiology</topic><topic>Pain - etiology</topic><topic>Pain Measurement</topic><topic>Rheumatoid Arthritis</topic><topic>Sweden - epidemiology</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Altawil, Reem</creatorcontrib><creatorcontrib>Saevarsdottir, Saedis</creatorcontrib><creatorcontrib>Wedrén, Sara</creatorcontrib><creatorcontrib>Alfredsson, Lars</creatorcontrib><creatorcontrib>Klareskog, Lars</creatorcontrib><creatorcontrib>Lampa, Jon</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><jtitle>Arthritis care & research (2010)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Altawil, Reem</au><au>Saevarsdottir, Saedis</au><au>Wedrén, Sara</au><au>Alfredsson, Lars</au><au>Klareskog, Lars</au><au>Lampa, Jon</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Remaining Pain in Early Rheumatoid Arthritis Patients Treated With Methotrexate</atitle><jtitle>Arthritis care & research (2010)</jtitle><addtitle>Arthritis Care Res (Hoboken)</addtitle><date>2016-08</date><risdate>2016</risdate><volume>68</volume><issue>8</issue><spage>1061</spage><epage>1068</epage><pages>1061-1068</pages><issn>2151-464X</issn><eissn>2151-4658</eissn><abstract>Objective
To investigate the frequency of remaining pain in early rheumatoid arthritis (RA) after 3 months of treatment with methotrexate as the only disease modifying antirheumatic drug, with a special focus on patients with a good clinical response.
Methods
The study base was cases reported to a population‐based early RA cohort who had followup data from the Swedish Rheumatology Quality Register (n = 1,241). The Disease Activity Score in 28 joints European League Against Rheumatism (EULAR) response criteria were used to evaluate clinical response to treatment as good, moderate, and no response. The primary end point was remaining pain at the 3‐months followup visit, defined as pain >20 mm on a 100‐mm visual analog scale (VAS).
Results
Remaining pain in spite of a EULAR good response at followup was associated with higher baseline disability, using the Health Assessment Questionnaire (adjusted odds ratio [OR] 2.2 [95% confidence interval (95% CI) 1.4–3.4] per unit increase), and less baseline inflammation, using the erythrocyte sedimentation rate (adjusted OR 0.81 [95% CI 0.70–0.93] per 10‐mm increase). Similar associations were detected for remaining pain at followup in spite of low inflammatory activity, defined as a C‐reactive protein level <10. Increase in VAS pain during the treatment period was observed in 19% of the whole cohort, with frequencies in the EULAR response groups of 9% (good response), 15% (moderate response), and 45% (no response).
Conclusion
These results are in line with the hypothesis that a subgroup of early RA patients exhibits pain that is not inflammatory mediated, where alternative treatment strategies to traditional antiinflammatory medications need to be considered.</abstract><cop>United States</cop><pub>John Wiley and Sons Inc</pub><pmid>26784398</pmid><doi>10.1002/acr.22790</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Arthritis care & research (2010), 2016-08, Vol.68 (8), p.1061-1068 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; SWEPUB Freely available online |
| subjects | Adult Antirheumatic Agents - therapeutic use Arthritis, Rheumatoid - complications Arthritis, Rheumatoid - drug therapy Case-Control Studies Female Humans Male Methotrexate - therapeutic use Middle Aged Odds Ratio Pain - epidemiology Pain - etiology Pain Measurement Rheumatoid Arthritis Sweden - epidemiology Treatment Outcome |
| title | Remaining Pain in Early Rheumatoid Arthritis Patients Treated With Methotrexate |
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