Evidence map›Paper›PMID 30221841›Full record

Trial reportArthritis care & research2019

Adverse Events and Resource Use Before and After Treat-to-Target in Rheumatoid Arthritis: A Post Hoc Analysis of a Randomized Controlled Trial.

Daniel H Solomon, Zhi Yu, Jeffrey N Katz, Asaf Bitton, Cassandra Corrigan, Liana Fraenkel, Leslie R Harrold, Josef S Smolen, Elena Losina, Bing Lu

Open access · bronzeAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Arthritis care & research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 34% 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

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. 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

10 authors at 4 institutions in 2 countries.

Daniel H SolomonBrigham and Women's Hospital, Boston, Massachusetts.
Zhi YuBrigham and Women's Hospital, Boston, Massachusetts.
Jeffrey N KatzBrigham and Women's Hospital, Boston, Massachusetts.
Asaf BittonBrigham and Women's Hospital, Boston, Massachusetts.
Cassandra CorriganBrigham and Women's Hospital, Boston, Massachusetts.
Liana FraenkelYale School of Medicine, New Haven, Connecticut.
Leslie R HarroldUniversity of Massachusetts Medical Center, Worcester.ORCID 0000-0002-0170-2747
Josef S SmolenUniversity of Vienna, Vienna, Austria.
Elena LosinaBrigham and Women's Hospital, Boston, Massachusetts.
Bing LuBrigham and Women's Hospital, Boston, Massachusetts.
Brigham and Women's Hospital · USUniversity of Massachusetts Chan Medical School · USUniversity of Vienna · ATYale University · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Trial of risk mangement for prevention of accelerated atherosclerosis in SLEP60AR047782 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI LOSINA, ELENA · 2001 to 2016
$18.8M
VERITY: Value and Evidence in Rheumatology using bioInformaTics, and advanced analYticsP30AR072577 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI Katherine Phoenix Liao · 2017 to 2026
$9.8M
Patient Centered Outcomes Research in RheumatologyK24AR055989 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI SOLOMON, DANIEL HAL · 2008 to 2017
$1.5M
Improving Decision Making in Patients with Rheumatic DiseaseK24AR060231 · NIAMS · YALE UNIVERSITY · PI FRAENKEL, LIANA · 2011 to 2018
$1.2M
NCATS NIH HHS UL1 TR001863NIAMS NIH HHS K24 AR055989NIAMS NIH HHS K24 AR060231NIAMS NIH HHS P30 AR072577NIAMS NIH HHS P60 AR047782
6 · The paper itself

Abstract

objectiveTreat-to-target (TTT) is an accepted paradigm for care of patients with rheumatoid arthritis (RA). Because TTT can be associated with more medication switches, concerns arise regarding whether implementing TTT may increase adverse events and/or resource use. The aim of this study was to examine adverse events and resource use during the preintervention and intervention periods of the TTT intervention trial.

methodsWe used data from 6 practices enrolled in an 18-month cluster-randomized controlled trial to compare adverse events and resource use before (months 1-9) and during (months 10-18) a TTT intervention. The outcomes of interest, adverse events and resource use, were based on medical record review of all rheumatology visits for RA patients before and during the intervention.

resultsWe examined records for 321 patients before the intervention and 315 during the intervention. An adverse event was recorded in 10.2% of visits before the intervention and 8.8% of visits during the intervention (P = 0.41). Biologic disease-modifying antirheumatic drugs were taken by 53.6% of patients before the intervention and 49.8% of patients during the intervention (P = 0.73). Rheumatology visits were more frequent before the intervention (mean ± SD 4.0 ± 1.4) than during the intervention (mean ± SD 3.6 ± 1.2; P = 0.02). More visits were accompanied by monitoring laboratory tests before the intervention (90.0%) compared with during the intervention (52.7%; P < 0.001). A greater percentage of visits before the intervention included diagnostic imaging (15.4%) versus during the intervention (8.9%; P < 0.001).

conclusionWe observed similar rates of adverse events before and during the implementation of TTT for RA. Rheumatology visits, use of laboratory monitoring, and diagnostic imaging did not increase during the TTT intervention.

Indexed as

AdultAgedAntirheumatic AgentsArthritis, RheumatoidChi-Square DistributionCluster AnalysisDose-Response Relationship, DrugDrug Administration ScheduleFemaleFollow-Up StudiesHealth ResourcesHumansMaleMiddle AgedMonitoring, PhysiologicRisk AssessmentAntirheumatic Agents

Identifiers

PMID30221841
PMCPMC6421109
OpenAlexW2891438911

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.