Evidence map›Paper›PMID 30886952›Full record

ArticleBMC rheumatology2018

Radiographic progression in early rheumatoid arthritis patients following initial combination versus step-up treat-to-target therapy in daily clinical practice: results from the DREAM registry.

Laura M M Steunebrink, Letty G A Versteeg, Harald E Vonkeman, Peter M Ten Klooster, Monique Hoekstra, Mart A F J van de Laar

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC rheumatology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
3.4field-weighted citation impact, top 8% 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

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Observational
  6. Review
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.

Laura M M Steunebrink1Arthritis Center Twente, Department of Rheumatology, Medisch Spectrum Twente, PO BOX 50 000, 7500 KA Enschede, The Netherlands.ORCID 0000-0002-7905-5076
Letty G A Versteeg1Arthritis Center Twente, Department of Rheumatology, Medisch Spectrum Twente, PO BOX 50 000, 7500 KA Enschede, The Netherlands.
Harald E Vonkeman1Arthritis Center Twente, Department of Rheumatology, Medisch Spectrum Twente, PO BOX 50 000, 7500 KA Enschede, The Netherlands.
Peter M Ten Klooster2Department of Psychology, Health & Technology, University of Twente, Enschede, The Netherlands.
Monique HoekstraDepartment of Rheumatology, Isala, Zwolle, The Netherlands.
Mart A F J van de Laar1Arthritis Center Twente, Department of Rheumatology, Medisch Spectrum Twente, PO BOX 50 000, 7500 KA Enschede, The Netherlands.
Medisch Spectrum Twente · NLIsala · NLUniversity of Twente · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly and intensive targeted treatment with disease modifying anti-rheumatic drugs (DMARDs) has been shown to lead to substantial reductions in disease activity and radiograph damage in patients with early rheumatoid arthritis (RA). The aim of this quasi-experimental study was to compare the first-year radiographic progression rates between a treat-to-target (T2 T) strategy with initial combination therapy (strategy II, started in 2012) versus an initial step-up monotherapy (strategy I, started in 2006).

methodsA total of 128 patients from strategy II was individually matched with 128 patients from strategy I on sex, age (± 5 yrs.) and baseline disease activity (± 0.5 on the DAS28). Differences in radiographic progression (Sharp/van der Heijde) scores (SHS) and the number of patients experiencing a minimal clinically important difference (MCID; ≥ 5 SHS points) between both strategies were tested with Mann Whitney U and chi-square tests. Next, linear and logistic regression analyses were performed to examine which baseline variables were associated with radiographic progression scores and the probability of experiencing an MCID within 1 year.

resultsPatients with initial combination therapy had slightly higher baseline disease activity scores and pain scores, but better mental health scores. Patients with initial monotherapy had significantly more, and more frequently clinically relevant, radiographic progression after 1 year. Experiencing a MCID was independently associated with fewer tender joints (

conclusionTreating early RA patients with initial combination therapy results in better radiographic outcomes than initial monotherapy in daily clinical practice.

trial registrationNetherlands Trial Register NTR578, 12 January 2006.

Indexed as

Early rheumatoid arthritisJoint damageRadiographic progressionRemissionTreat-to-target (T2 T)

Identifiers

PMID30886952
PMCPMC6390778
OpenAlexW2793440096

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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.