Treatment of early rheumatoid arthritis in a multinational inception cohort of Latin American patients: The GLADAR experience

Background Treatment of rheumatoid arthritis (RA) has evolved dramatically in the last decade. However, little is known about the way rheumatologists in Latin America treat their patients in clinical practice, outside the scope of clinical trials. Objective The objective of this study was to describ...

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Tipo de recurso:
Fecha de publicación:
2012
Institución:
Universidad del Rosario
Repositorio:
Repositorio EdocUR - U. Rosario
Idioma:
eng
OAI Identifier:
oai:repository.urosario.edu.co:10336/27134
Acceso en línea:
https://doi.org/10.1097/RHU.0b013e31826d6610
https://repository.urosario.edu.co/handle/10336/27134
Palabra clave:
Treatment
Rheumatoid arthritis
Corticosteroids
Disease-modifying antirheumatic drugs
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License
Restringido (Acceso a grupos específicos)
id EDOCUR2_2a417af5b1fb4360a26394e3d6243deb
oai_identifier_str oai:repository.urosario.edu.co:10336/27134
network_acronym_str EDOCUR2
network_name_str Repositorio EdocUR - U. Rosario
repository_id_str
dc.title.spa.fl_str_mv Treatment of early rheumatoid arthritis in a multinational inception cohort of Latin American patients: The GLADAR experience
dc.title.TranslatedTitle.spa.fl_str_mv Tratamiento de la artritis reumatoide temprana en una cohorte de inicio multinacional de pacientes latinoamericanos: la experiencia GLADAR
title Treatment of early rheumatoid arthritis in a multinational inception cohort of Latin American patients: The GLADAR experience
spellingShingle Treatment of early rheumatoid arthritis in a multinational inception cohort of Latin American patients: The GLADAR experience
Treatment
Rheumatoid arthritis
Corticosteroids
Disease-modifying antirheumatic drugs
title_short Treatment of early rheumatoid arthritis in a multinational inception cohort of Latin American patients: The GLADAR experience
title_full Treatment of early rheumatoid arthritis in a multinational inception cohort of Latin American patients: The GLADAR experience
title_fullStr Treatment of early rheumatoid arthritis in a multinational inception cohort of Latin American patients: The GLADAR experience
title_full_unstemmed Treatment of early rheumatoid arthritis in a multinational inception cohort of Latin American patients: The GLADAR experience
title_sort Treatment of early rheumatoid arthritis in a multinational inception cohort of Latin American patients: The GLADAR experience
dc.subject.keyword.spa.fl_str_mv Treatment
Rheumatoid arthritis
Corticosteroids
Disease-modifying antirheumatic drugs
topic Treatment
Rheumatoid arthritis
Corticosteroids
Disease-modifying antirheumatic drugs
description Background Treatment of rheumatoid arthritis (RA) has evolved dramatically in the last decade. However, little is known about the way rheumatologists in Latin America treat their patients in clinical practice, outside the scope of clinical trials. Objective The objective of this study was to describe treatment patterns at disease onset in early RA with data from a large, multicenter, multinational inception cohort of Latin American patients. Methods Consecutive patients with early RA (<1 year of disease duration as diagnosed by a rheumatologist) from 46 centers in 14 Latin American countries were enrolled in the study. Clinical data, laboratory assessments, and a detailed registry on type of prescriptions were collected at baseline and at 3, 6, 12, 18, and 24 months of follow-up. Hands and feet x-rays were obtained at baseline and at 12 and 24 months. All data were captured in Arthros 6.1 database. Continuous variables were expressed as means and SDs, and categorical variables were expressed as percentages and 95% confidence intervals (95% CIs). Only therapeutic data at baseline are presented, corresponding to the period between disease onset and second visit (3 months). Results A total of 1093 patients were included. Eighty-five percent were female, and 76% had a positive rheumatoid factor. Mean age at diagnosis was 46.5 (SD, 14.2) years, and mean disease duration at the first visit was 5.8 (SD, 3.8) months. Between baseline and second visit (3 months), 75% of patients (95% CI, 72%–78%) received disease-modifying antirheumatic drugs. Methotrexate (MTX) alone or in combination was the most frequently used (60.5%), followed by antimalarials (chloroquine or hydroxychloroquine, 32.1%), sulfasalazine (7.1%), and leflunomide (LEF, 4%). In 474 patients (43%), initiation of disease-modifying antirheumatic drugs was within the first month after the first visit. In addition, 290 patients (26%; 95% CI, 23%–29%) received combination therapy as initial treatment. The most frequently used combinations were MTX + chloroquine (45%), MTX + hydroxychloroquine (25%), and MTX + sulfasalazine (16%). Eleven patients (1%; 95% CI, 0.5%–1.8%) received biologics. Sixty-four percent (95% CI, 60%–66%) received corticosteroids. Of those, 80% (95% CI, 77%–84%) received 10 mg of oral prednisone or less. Conclusions In this cohort of Latin American patients with early RA, most patients received MTX very early in their disease course. Combination therapy was used approximately in 1 of every 4 patients as initial therapy. Biologics were rarely used at this early stage, and low-dose prednisone was commonly used.
publishDate 2012
dc.date.created.spa.fl_str_mv 2012-10
dc.date.accessioned.none.fl_str_mv 2020-08-19T14:41:06Z
dc.date.available.none.fl_str_mv 2020-08-19T14:41:06Z
dc.type.eng.fl_str_mv article
dc.type.coarversion.fl_str_mv http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_6501
dc.type.spa.spa.fl_str_mv Artículo
dc.identifier.doi.none.fl_str_mv https://doi.org/10.1097/RHU.0b013e31826d6610
dc.identifier.issn.none.fl_str_mv ISSN: 1076-1608
EISSN: 1536-7355
dc.identifier.uri.none.fl_str_mv https://repository.urosario.edu.co/handle/10336/27134
url https://doi.org/10.1097/RHU.0b013e31826d6610
https://repository.urosario.edu.co/handle/10336/27134
identifier_str_mv ISSN: 1076-1608
EISSN: 1536-7355
dc.language.iso.spa.fl_str_mv eng
language eng
dc.relation.citationEndPage.none.fl_str_mv 335
dc.relation.citationIssue.none.fl_str_mv No. 7
dc.relation.citationStartPage.none.fl_str_mv 327
dc.relation.citationTitle.none.fl_str_mv Journal of Clinical Rheumatology
dc.relation.citationVolume.none.fl_str_mv Vol. 18
dc.relation.ispartof.spa.fl_str_mv Journal of Clinical Rheumatology, ISSN: 1076-1608;EISSN: 1536-7355, Vol.18, No.7 (October 2012); pp. 327-335
dc.relation.uri.spa.fl_str_mv https://journals.lww.com/jclinrheum/Abstract/2012/10000/Treatment_of_Early_Rheumatoid_Arthritis_in_a.2.aspx
dc.rights.coar.fl_str_mv http://purl.org/coar/access_right/c_16ec
dc.rights.acceso.spa.fl_str_mv Restringido (Acceso a grupos específicos)
rights_invalid_str_mv Restringido (Acceso a grupos específicos)
http://purl.org/coar/access_right/c_16ec
dc.format.mimetype.none.fl_str_mv application/pdf
dc.publisher.spa.fl_str_mv Wolters Kluwer Health
dc.source.spa.fl_str_mv Journal of Clinical Rheumatology
institution Universidad del Rosario
dc.source.instname.none.fl_str_mv instname:Universidad del Rosario
dc.source.reponame.none.fl_str_mv reponame:Repositorio Institucional EdocUR
repository.name.fl_str_mv Repositorio institucional EdocUR
repository.mail.fl_str_mv edocur@urosario.edu.co
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spelling ae1dc5f8-6b02-448f-9019-d9b86059931a-128a11ecc-4e3c-440e-bc2c-07c632e8a4c9-1bbf3ffe4-b975-44b8-a9f3-5c2a943cb0aa-14488b463-91eb-46f5-be32-4323e14c981a-1397054e3-1007-4a1c-b51f-27939b0c6249-152249701-12020-08-19T14:41:06Z2020-08-19T14:41:06Z2012-10Background Treatment of rheumatoid arthritis (RA) has evolved dramatically in the last decade. However, little is known about the way rheumatologists in Latin America treat their patients in clinical practice, outside the scope of clinical trials. Objective The objective of this study was to describe treatment patterns at disease onset in early RA with data from a large, multicenter, multinational inception cohort of Latin American patients. Methods Consecutive patients with early RA (<1 year of disease duration as diagnosed by a rheumatologist) from 46 centers in 14 Latin American countries were enrolled in the study. Clinical data, laboratory assessments, and a detailed registry on type of prescriptions were collected at baseline and at 3, 6, 12, 18, and 24 months of follow-up. Hands and feet x-rays were obtained at baseline and at 12 and 24 months. All data were captured in Arthros 6.1 database. Continuous variables were expressed as means and SDs, and categorical variables were expressed as percentages and 95% confidence intervals (95% CIs). Only therapeutic data at baseline are presented, corresponding to the period between disease onset and second visit (3 months). Results A total of 1093 patients were included. Eighty-five percent were female, and 76% had a positive rheumatoid factor. Mean age at diagnosis was 46.5 (SD, 14.2) years, and mean disease duration at the first visit was 5.8 (SD, 3.8) months. Between baseline and second visit (3 months), 75% of patients (95% CI, 72%–78%) received disease-modifying antirheumatic drugs. Methotrexate (MTX) alone or in combination was the most frequently used (60.5%), followed by antimalarials (chloroquine or hydroxychloroquine, 32.1%), sulfasalazine (7.1%), and leflunomide (LEF, 4%). In 474 patients (43%), initiation of disease-modifying antirheumatic drugs was within the first month after the first visit. In addition, 290 patients (26%; 95% CI, 23%–29%) received combination therapy as initial treatment. The most frequently used combinations were MTX + chloroquine (45%), MTX + hydroxychloroquine (25%), and MTX + sulfasalazine (16%). Eleven patients (1%; 95% CI, 0.5%–1.8%) received biologics. Sixty-four percent (95% CI, 60%–66%) received corticosteroids. Of those, 80% (95% CI, 77%–84%) received 10 mg of oral prednisone or less. Conclusions In this cohort of Latin American patients with early RA, most patients received MTX very early in their disease course. Combination therapy was used approximately in 1 of every 4 patients as initial therapy. Biologics were rarely used at this early stage, and low-dose prednisone was commonly used.application/pdfhttps://doi.org/10.1097/RHU.0b013e31826d6610ISSN: 1076-1608EISSN: 1536-7355https://repository.urosario.edu.co/handle/10336/27134engWolters Kluwer Health335No. 7327Journal of Clinical RheumatologyVol. 18Journal of Clinical Rheumatology, ISSN: 1076-1608;EISSN: 1536-7355, Vol.18, No.7 (October 2012); pp. 327-335https://journals.lww.com/jclinrheum/Abstract/2012/10000/Treatment_of_Early_Rheumatoid_Arthritis_in_a.2.aspxRestringido (Acceso a grupos específicos)http://purl.org/coar/access_right/c_16ecJournal of Clinical Rheumatologyinstname:Universidad del Rosarioreponame:Repositorio Institucional EdocURTreatmentRheumatoid arthritisCorticosteroidsDisease-modifying antirheumatic drugsTreatment of early rheumatoid arthritis in a multinational inception cohort of Latin American patients: The GLADAR experienceTratamiento de la artritis reumatoide temprana en una cohorte de inicio multinacional de pacientes latinoamericanos: la experiencia GLADARarticleArtículohttp://purl.org/coar/version/c_970fb48d4fbd8a85http://purl.org/coar/resource_type/c_6501Cardiel, Mario H.Pons-Estel, Bernardo A.Sacnun, Mónica P.Wojdyla, DanielSaurit, VerónicaRojas-Villarraga, Adriana10336/27134oai:repository.urosario.edu.co:10336/271342022-05-02 07:37:21.890933https://repository.urosario.edu.coRepositorio institucional EdocURedocur@urosario.edu.co