Trial reportBMC musculoskeletal disorders2009
Use of risk stratification to target therapies in patients with recent onset arthritis; design of a prospective randomized multicenter controlled trial.
Trial report in BMC musculoskeletal disorders, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed.
- Treat-to-target strategies are feasible in elderly-onset rheumatoid arthritis given its reassuring risk-benefit profile.RMD open · 2026Trial
- Comparing cost-utility of DMARDs in autoantibody-negative rheumatoid arthritis patients.Rheumatology (Oxford, England) · 2021Trial
- Higher baseline global leukocyte DNA methylation is associated with MTX non-response in early RA patients.Arthritis research & therapy · 2019Trial
- Randomised comparison of initial triple DMARD therapy with methotrexate monotherapy in combination with low-dose glucocorticoid bridging therapy; 1-year data of the tREACH trial.Annals of the rheumatic diseases · 2014Trial
- In vitro glucocorticoid sensitivity is associated with clinical glucocorticoid therapy outcome in rheumatoid arthritis.Arthritis research & therapy · 2012Trial
- Eye-openers for advanced management of elderly-onset rheumatoid arthritis.Rheumatology (Oxford, England) · 2025Article
- Smoking as a risk factor for rheumatoid arthritis: predominant association with IgA autoantibodies - comprehensive analysis of anti-modified protein antibodies with smoking and genetic risk factors in rheumatoid arthritis.Arthritis research & therapy · 2025Article
- Article
- Combining patient-reported outcome measures to screen for active disease in rheumatoid arthritis and psoriatic arthritis.RMD open · 2024Article
- The prognostic value of IgA anti-citrullinated protein antibodies and rheumatoid factor in an early arthritis population with a treat-to-target approach.Immunologic research · 2024Article
- Patients with rheumatoid arthritis presenting with mono- or oligo-arthritis and high VAS-ratings remain the most fatigued during 5 years of follow-up.Rheumatology (Oxford, England) · 2024Article
- Article
- Health-related quality of life (HRQoL) from HIV patients' perspective: comparison of patient-reported outcome (PRO) measures among people living with hiv (PLWH) and other chronic clinical conditions.Journal of patient-reported outcomes · 2022Article
- The impact of different (rheumatoid) arthritis phenotypes on patients' lives.Rheumatology (Oxford, England) · 2021Article
- The number of risk factors for persistent disease determines the clinical course of early arthritis.Rheumatology (Oxford, England) · 2021Article
- Complex Machine-Learning Algorithms and Multivariable Logistic Regression on Par in the Prediction of Insufficient Clinical Response to Methotrexate in Rheumatoid Arthritis.Journal of personalized medicine · 2021Article
- Identification of Metabolic Biomarkers in Relation to Methotrexate Response in Early Rheumatoid Arthritis.Journal of personalized medicine · 2020Article
- Fatigue in early, intensively treated and tight-controlled rheumatoid arthritis patients is frequent and persistent: a prospective study.Rheumatology international · 2018Article
- Article
- A five-year model to assess the early cost-effectiveness of new diagnostic tests in the early diagnosis of rheumatoid arthritis.Arthritis research & therapy · 2016Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly and intensive treatment is important to inducing remission and preventing joint damage in patients with rheumatoid arthritis. While intensive combination therapy (Disease Modifying Anti-rheumatic Drugs and/or biologicals) is the most effective, rheumatologists in daily clinical practice prefer to start with monotherapy methotrexate and bridging corticosteroids. Intensive treatment should be started as soon as the first symptoms manifest, but at this early stage, ACR criteria may not be fulfilled, and there is a danger of over-treatment. We will therefore determine which induction therapy is most effective in the very early stage of persistent arthritis. To overcome over-treatment and under-treatment, the intensity of induction therapy will be based on a prediction model that predicts patients' propensity for persistent arthritis.
methodsA multicenter stratified randomized single-blind controlled trial is currently being performed in patients 18 years or older with recent-onset arthritis. Eight hundred ten patients are being stratified according to the likelihood of their developing persistent arthritis. In patients with a high probability of persistent arthritis, we will study combination Disease Modifying Antirheumatic Drug therapy compared to monotherapy methotrexate. In patients with an intermediate probability of persistent arthritis, we will study Disease Modifying Antirheumatic Drug of various intensities. In patients with a low probability, we will study non-steroidal anti-inflammatory drugs, hydroxychloroquine and a single dose of corticosteroids. If disease activity is not sufficiently reduced, treatment will be adjusted according to a step-up protocol. If remission is achieved for at least six months, medication will be tapered off. Patients will be followed up every three months over two years. DISCUSSION: This is the first rheumatological study to base treatment in early arthritis on a prediction rule. Treatment will be stratified according to the probability of persistent arthritis, and different combinations of treatment per stratum will be evaluated. Treatment will be started early, and patients will not need to meet the ACR-criteria for rheumatoid arthritis.
trial registrationThis trial has been registered in Current Controlled Trials with the ISRCTN26791028.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.