Trial reportRMD open2020
Earlier is better when treating rheumatoid arthritis: but can we detect a window of opportunity?
Trial report in RMD open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 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.
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Who cites it
14 citing papers in PubMed, 21 citations in OpenAlex.
- MMP3C v2: a network-based framework decoding metabolic plasticity in rheumatoid arthritis, enabling accurate diagnosis and uncovering cell-type-specific metabolic rewiring.Briefings in bioinformatics · 2026Article
- Joint accumulation and sustained remission in early rheumatoid arthritis.Journal of rheumatic diseases · 2026Article
- Comparing clinical outcomes of rheumatoid arthritis by onset type: palindromic rheumatism, undifferentiated arthritis, and typical rheumatoid arthritis.Clinical rheumatology · 2026Article
- Selective use of musculoskeletal ultrasound in rheumatoid arthritis: from subclinical inflammation to clinical decision-making.Rheumatology international · 2026Review
- Association of 14-3-3η with Tumor Necrosis Factor (TNF-α) and Matrix Metalloproteinase-1 (MMP-1) in Rheumatoid Arthritis.Current rheumatology reviews · 2026Article
- Short- and long-term sustained remission and the role of joint accumulation in early and very early rheumatoid arthritis: a real-world perspective.Journal of rheumatic diseases · 2026Article
- Article
- Musculoskeletal ultrasonography versus conventional radiography: Correlation with DAS28 and MDHAQ scores in early rheumatoid arthritis.The Journal of international medical research · 2024Article
- Joint-specific memory, resident memory T cells and the rolling window of opportunity in arthritis.Nature reviews. Rheumatology · 2024Review
- Joint-Specific Memory and Sustained Risk for New Joint Accumulation in Autoimmune Arthritis.Arthritis & rheumatology (Hoboken, N.J.) · 2022Article
- Mechanism-driven strategies for prevention of rheumatoid arthritis.Rheumatology & autoimmunity · 2022Article
- Pre-RA: Can early diagnosis lead to prevention?Best practice & research. Clinical rheumatology · 2022Review
- Can treating rheumatoid arthritis with disease-modifying anti-rheumatic drugs at the window of opportunity with tight control strategy lead to long-term remission and medications free remission in real-world clinical practice? A cohort study.Clinical rheumatology · 2021Article
- Cross-Tissue Transcriptomic Analysis Leveraging Machine Learning Approaches Identifies New Biomarkers for Rheumatoid Arthritis.Frontiers in immunology · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe window of opportunity (WOO) hypothesis suggests a limited time frame to stop rheumatoid arthritis (RA). We hypothesised that a WOO could either be represented by a hyperbolic ('curved') decline in the chance to achieve the outcome sustained drug-free remission (sDFR) over time, after which achieving sDFR is not possible anymore, or by a more gradual linear decline approaching zero chance to achieve sDFR.
methodsPatients with RA (symptom duration <2 years) were included from two randomised trials: BehandelStrategieën (BeSt), n=508 and Induction therapy with Methotrexate and Prednisone in Rheumatoid Or Very Early arthritic Disease (IMPROVED), n=479. Cox-regression was performed to assess the shape of the association between symptom duration and sDFR (Disease Activity Score<1.6, no disease-modifying anti-rheumatic drugs for ≥1 year) for patients starting slow-acting monotherapy (IMPROVED, BeSt) or fast-acting combination therapy (BeSt). Likelihood ratio tests were used to compare the fit of linear and non-linear models in both databases separately. Predictions from the best fitting models were used to assess whether the absolute risk to achieve sDFR approaches zero with increasing symptom duration.
resultsIn BeSt and IMPROVED, 54/226 and 110/421 patients achieved sDFR with fast-acting treatment, and 53/243 (BeSt) with slow-acting treatment. Non-linear models did not fit better than linear models (fast-acting treatment BeSt p=0.743, IMPROVED p=0.337; slow-acting treatment BeSt p=0.609). After slow-acting monotherapy, linear models declined steeper. None of the models approached zero chance to achieve sDFR over time.
conclusionsThe chance to achieve sDFR decreased gradually over time, and decreased fastest in patients starting slow-acting monotherapy. In both treatment groups, we found no evidence for a WOO within 2 years symptom duration.
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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.