Evidence map›Paper›PMID 24907035›Full record

ArticleClinical rheumatology2014

Survival of disease-modifying antirheumatic drugs used as the first antirheumatic medication in the treatment of ankylosing spondylitis in Finland. A nationwide population-based register study.

Heikki Relas, Hannu Kautiainen, Kari Puolakka, Lauri J Virta, Marjatta Leirisalo-Repo

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Article in Clinical rheumatology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Heikki RelasDepartment of Medicine, Division of Rheumatology, Helsinki University Central Hospital, PO BOX 372, FI-00029 HUS, Helsinki, Finland, heikki.relas@gmail.com.
Hannu Kautiainen
Kari Puolakka
Lauri J Virta
Marjatta Leirisalo-Repo

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The tight national drug reimbursement regulations in the treatment of ankylosing spondylitis (AS) in Finland lead to the practice that at least one traditional disease-modifying antirheumatic drug (DMARD), if not contraindicated, has been tried and has failed before a patient can be eligible for reimbursement of anti-tumour necrosis factor (TNF) treatment. The aim of the present study is to evaluate drug survival of the firstly prescribed DMARDs in patients with AS. All AS patients from January 1, 2000 to December 31, 2007 were collected from the nationwide drug reimbursement registry maintained by the Social Insurance Institution (SII). Data on antirheumatic medication came from the prescription registry of SII. A total of 2,890 AS patients (60 % males) were identified. Sulfasalazine (SSA) monotherapy was the most common first antirheumatic treatment (2,319 patients, 87 %), followed by methotrexate (MTX) monotherapy (230 patients, 9 %) and by hydroxychloroquine monotherapy (77 patients, 3 %). A combination of two or more DMARDs was used by 44 patients (2 %). Only seven patients (0.3 %) had biological (etanercept or adalimumab) started as the first antirheumatic drug. Median survival time of SSA monotherapy was 4.5 years (95 % CI 4.2 to 4.8) and that of MTX was 1.9 years (95 % CI 1.5 to 2.1). SSA is almost the standard as the first antirheumatic treatment of AS in Finland. Although the clinical efficiency of SSA was not evaluable in the present study, these data suggest that the use of SSA can at least postpone the need and start of TNF inhibitors with marked economic consequences.

Indexed as

AdultAntirheumatic AgentsDrug Therapy, CombinationEtanerceptFemaleFinlandHumansHydroxychloroquineImmunoglobulin GMaleMethotrexateMiddle AgedReceptors, Tumor Necrosis FactorRegistriesRetreatmentSpondylitis, AnkylosingAntirheumatic AgentsEtanerceptHydroxychloroquineImmunoglobulin GMethotrexateReceptors, Tumor Necrosis Factor

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Registered trials

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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.