Evidence map›Paper›PMID 28941147›Full record

Observational studyArthritis care & research2018

Timing and Impact of Decisions to Adjust Disease-Modifying Antirheumatic Drug Therapy for Rheumatoid Arthritis Patients With Active Disease.

Yomei Shaw, Chung-Chou H Chang, Marc C Levesque, Julie M Donohue, Kaleb Michaud, Mark S Roberts

Abstract readObservational Study
In one paragraph

Observational study in Arthritis care & research, 2018. 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
0.7field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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, 6 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Yomei ShawUniversity of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.ORCID 0000-0001-7048-8687
Chung-Chou H ChangUniversity of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Marc C LevesqueAbbVie, Worcester, Massachusetts.
Julie M DonohueUniversity of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
Kaleb MichaudUniversity of Nebraska Medical Center, Lincoln, and National Data Bank for Rheumatic Diseases, Wichita, Kansas.ORCID 0000-0002-5350-3934
Mark S RobertsUniversity of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
University of Pittsburgh · USAbbVie (United States) · USThe National Databank for Rheumatic Diseases · US

Funding

Randomized observation study of biologic therapy for rheumatoid arthritisRC2AR058989 · NIAMS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI LEVESQUE, MARC C., MORELAND, LARRY W · 2009 to 2010
$2.9M
NIAMS NIH HHS RC2 AR058989
6 · The paper itself

Abstract

objectiveGuidelines recommend that rheumatoid arthritis (RA) patients with moderate-to-high disease activity (MHDAS) adjust disease-modifying antirheumatic drug (DMARD) therapy at least every 3 months until reaching low disease activity or remission (LDAS). We examined how quickly RA patients with MHDAS adjust DMARD therapy in clinical practice, and whether those who adjust DMARDs within 90 days in response to MHDAS reach LDAS sooner.

methodsWe identified RA patients with MHDAS in the University of Pittsburgh Rheumatoid Arthritis Comparative Effectiveness Research registry, and conducted a competing risks regression on time to DMARD therapy adjustment and a Cox regression on time to LDAS.

resultsWe identified 538 eligible subjects with 943.5 patient-years of followup. Sixty percent of patients with persistent MHDAS adjusted DMARDs within 90 days. Among all subjects, median times to DMARD adjustment and LDAS were 154 (interquartile range [IQR] 1-706) days and 301 (IQR 140-706) days, respectively. Being elderly (subdistribution hazard ratio [SHR] 0.61, P = 0.02), lower baseline disease activity (SHR 0.72, P < 0.01), longer duration of RA (SHR 0.98, P < 0.01), and biologic use (SHR 0.71, P < 0.01) were significantly associated with longer times to therapy adjustment. African American race (hazard ratio [HR] 0.63, P = 0.01), higher baseline disease activity (HR 0.75, P < 0.01), and not adjusting DMARD therapy within 90 days (HR 0.76, P = 0.01) were associated with longer times to LDAS.

conclusionAdjusting DMARDs within 90 days was associated with shorter times to LDAS, but many patients with persistent MHDAS waited >90 days to adjust DMARDs. Interventions are needed to address the timeliness of DMARD adjustments for RA patients with MHDAS.

Indexed as

RegistriesAgedAntirheumatic AgentsArthritis, RheumatoidFemaleHumansMaleMiddle AgedSeverity of Illness IndexTime FactorsAntirheumatic Agents

Identifiers

PMID28941147
PMCPMC5862728
OpenAlexW2758107218

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.