Evidence map›Paper›PMID 37297917›Full record

ArticleJournal of clinical medicine2023

Physical Function of RA patients Tapering Treatment-A Post Hoc Analysis of the Randomized Controlled RETRO Trial.

Marlene Stephan, Koray Tascilar, Melek Yalcin-Mutlu, Melanie Hagen, Judith Haschka, Michaela Reiser, Fabian Hartmann, Arnd Kleyer, Axel J Hueber, Bernhard Manger and 20 more

Open access · goldAbstract read
In one paragraph

Article in Journal of clinical medicine, 2023. 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
0.5field-weighted citation impact, top 33% 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, 2 citations in OpenAlex.

  1. 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

30 authors at 12 institutions in 2 countries.

Marlene StephanDepartment of Internal Medicine 3, FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany.ORCID 0009-0009-6555-4964
Koray TascilarDepartment of Internal Medicine 3, FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany.
Melek Yalcin-MutluDepartment of Internal Medicine 3, FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany.ORCID 0000-0003-0598-5737
Melanie HagenDepartment of Internal Medicine 3, FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany.
Judith HaschkaKarl Landsteiner Institute for Gastroenterology and Rheumatology, 1100 Vienna, Austria.
Michaela ReiserDepartment of Internal Medicine 3, FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany.
Fabian HartmannDepartment of Internal Medicine 3, FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany.
Arnd KleyerDepartment of Internal Medicine 3, FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany.ORCID 0000-0002-2026-7728
Axel J HueberDepartment of Internal Medicine 3, FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany.
Bernhard MangerDepartment of Internal Medicine 3, FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany.ORCID 0000-0003-2375-0069
Camille FigueiredoInstitutio de Rheumatologia, Sao Paolo 01317-001, Brazil.ORCID 0000-0003-1102-8175
Jayme Fogagnolo CobraInstitutio de Rheumatologia, Sao Paolo 01317-001, Brazil.
Hans-Peter TonyRheumatology/Clinical Immunology, Department of Internal Medicine II, University of Würzburg, 97080 Würzburg, Germany.
Stephanie FinzelDepartment of Rheumatology and Clinical Immunology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany.ORCID 0000-0002-7625-9612
Stefan KleinertRheumatology Clinical Practice Erlangen, 91054 Erlangen, Germany.
Jörg WendlerRheumatology Clinical Practice Erlangen, 91054 Erlangen, Germany.
Florian SchuchRheumatology Clinical Practice Erlangen, 91054 Erlangen, Germany.ORCID 0000-0002-2543-0491
Monika RonnebergerRheumatology Clinical Practice Erlangen, 91054 Erlangen, Germany.
Martin FeuchtenbergerRheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, 84489 Burghausen, Germany.ORCID 0000-0001-8028-8099
Martin FleckAsklepios Medical Center, Department of Rheumatology and Clinical Immunology, 93077 Bad Abbach, Germany.
Karin MangerRheumatology Practice Bamberg, 96047 Bamberg, Germany.
Wolfgang OchsRheumatology Practice Bayreuth, 95444 Bayreuth, Germany.
Matthias Schmitt-HaendleRheumatology Practice Bayreuth, 95444 Bayreuth, Germany.
Hannes Martin LorenzDepartment of Medicine V, Center for Rheumatic Diseases Baden-Baden, University Hospital Heidelberg, 69120 Heidelberg, Germany.
Hubert NüssleinRheumatology Practice Nürnberg, 90429 Nürnberg, Germany.
Rieke AltenSchlosspark Klinik, Internal Medicine/Rheumatology, 14059 Berlin, Germany.
Joerg HenesCentre for Interdisciplinary Clinical Immunology, University of Tübingen, 72076 Tübingen, Germany.ORCID 0000-0002-8385-6861
Klaus KrügerPraxiszentrum St. Bonifatius, 81541 Munich, Germany.
Georg SchettDepartment of Internal Medicine 3, FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany.
Jürgen RechDepartment of Internal Medicine 3, FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany.
Universitätsklinikum Erlangen · DEBayreuth Medical Center · DEAsklepios Kliniken Bad Abbach · DEHanusch Hospital · ATHeidelberg University · DEMedias Klinikum · DESchlosspark-Klinik · DESt. Bonifatius Hospital · DEUniversity of Bamberg · DEUniversity of Freiburg · DEUniversity of Tübingen · DEUniversity of Würzburg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Several studies have shown that tapering or stopping disease-modifying anti-rheumatic drugs (DMARDs) in rheumatoid arthritis (RA) patients in sustained remission is feasible. However, tapering/stopping bears the risk of decline in physical function as some patients may relapse and face increased disease activity. Here, we analyzed the impact of tapering or stopping DMARD treatment on the physical function of RA patients. The study was a post hoc analysis of physical functional worsening for 282 patients with RA in sustained remission tapering and stopping DMARD treatment in the prospective randomized RETRO study. HAQ and DAS-28 scores were determined in baseline samples of patients continuing DMARD (arm 1), tapering their dose by 50% (arm 2), or stopping after tapering (arm 3). Patients were followed over 1 year, and HAQ and DAS-28 scores were evaluated every 3 months. The effect of treatment reduction strategy on functional worsening was assessed in a recurrent-event Cox regression model with a study-group (control, taper, and taper/stop) as the predictor. Two-hundred and eighty-two patients were analyzed. In 58 patients, functional worsening was observed. The incidences suggest a higher probability of functional worsening in patients tapering and/or stopping DMARDs, which is likely due to higher relapse rates in these individuals. At the end of the study, however, functional worsening was similar among the groups. Point estimates and survival curves show that the decline in functionality according to HAQ after tapering or discontinuation of DMARDs in RA patients with stable remission is associated with recurrence, but not with an overall functional decline.

Indexed as

DAS28DMARDHAQPROM’sRheumatoid Arthritis

Identifiers

PMID37297917
PMCPMC10253840
OpenAlexW4378619142

What OpenQuestion holds

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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.