Low-Dose Prednisone Inclusion in a Methotrexate-Based, Tight Control Strategy for Early Rheumatoid Arthritis A Randomized Trial Full Text
Annals of Internal Medicine,  Clinical Article

Bakker MF et al. – Inclusion of low–dose prednisone in an methotrexate (MTX)–based treatment strategy for tight control in early rheumatoid arthritis (RA) improves patient outcomes.

Methods
  • A 2–year, prospective, randomized, placebo–controlled, double–blind, multicenter trial (CAMERA–II [Computer Assisted Management in Early Rheumatoid Arthritis trial–II]).
  • 7 hospitals in the Netherlands.
  • 236 patients with early RA (duration <1 year).
  • Patients were randomly assigned to an MTX–based, tight control strategy starting with either MTX and prednisone or MTX and placebo.
  • Methotrexate treatment was tailored to the individual patient at monthly visits on the basis of predefined response criteria aiming for remission.
  • The primary outcome was radiographic erosive joint damage after 2 years.
  • Secondary outcomes included response criteria, remission, and the need to add cyclosporine or a biologic agent to the treatment.

Results
  • Erosive joint damage after 2 years was limited and less in the group receiving MTX and prednisone (n = 117) than in the group receiving MTX and placebo (n = 119).
  • The MTX and prednisone strategy was also more effective in reducing disease activity and physical disability, achieving sustained remission, and avoiding the addition of cyclosporine or biologic treatment.
  • Adverse events were similar in both groups, but some occurred less in the MTX and prednisone group.

Please login or register to follow this author.
► Click here to access Full Text, PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Rheumatology

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Rheumatology Articles

1 Homeopathy in the treatment of fibromyalgia- A comprehensive literature-review and meta-analysis Complementary Therapies in Medicine, August 15, 2014    Evidence Based Medicine    Review Article

2 Coffee or tea consumption and the risk of rheumatoid arthritis: A meta-analysis Clinical Rheumatology, October 15, 2014    Clinical Article

3 The comparative safety of TNF inhibitors in rheumatoid arthritis - a meta-analysis update of 44 randomized controlled trials American Journal of Medicine, October 6, 2014    Clinical Article

4 Drug-associated cutaneous vasculitis: Study of 239 patients from a single referral center The Journal of Rheumatology, September 25, 2014    Clinical Article

5 Rituximab for the treatment of relapses in ANCA-associated vasculitis Arthritis & Rheumatism, August 1, 2014    Clinical Article

6 Lupus classification criteria expanded; treat-to-target approach gains support Full Text The Rheumatologist, July 24, 2014    Free full text

7 Fish consumption and risk of rheumatoid arthritis: A dose-response meta-analysis Arthritis Research & Therapy, October 8, 2014    Evidence Based Medicine    Review Article

8 The impact of statins therapy on disease activity and inflammatory factor in patients with rheumatoid arthritis: A meta-analysis Clinical and Experimental Rheumatology Online, October 27, 2014    Evidence Based Medicine    Clinical Article

9 Efficacy and safety of ginger in osteoarthritis patients: A meta-analysis of randomized placebo-controlled trials Osteoarthritis and Cartilage , October 28, 2014    Evidence Based Medicine    Clinical Article

10 Early predictors of prognosis in juvenile idiopathic arthritis: A systematic literature review Annals of Rheumatic Diseases, August 29, 2014    Review Article

11 Homeopathy in the treatment of fibromyalgia—A comprehensive literature-review and meta-analysis Complementary Therapies in Medicine, October 9, 2014    Clinical Article

12 Alcohol consumption as a preventive factor for developing rheumatoid arthritis: A dose-response meta-analysis of prospective studies Annals of Rheumatic Diseases, October 24, 2014    Evidence Based Medicine    Clinical Article

13 Cost-utility of cognitive behavioural therapy versus U.S. food and drug administration recommended drugs and usual care in the treatment of patients with fibromyalgia: An economic evaluation alongside a 6-month randomised controlled trial Arthritis Research & Therapy, October 7, 2014    Clinical Article

14 Baseline serum level of matrix metalloproteinase-3 as a biomarker of progressive joint damage in rheumatoid arthritis patients International Journal of Rheumatic Diseases, October 17, 2014    Clinical Article

15 Targeted treatment with a combination of traditional DMARDs produces excellent clinical and radiographic long-term outcomes in early rheumatoid arthritis regardless of initial infliximab: The 5-year follow-up results of a randomised clinical trial, the NEO-RACo trial Annals of Rheumatic Diseases, October 23, 2014    Clinical Article

16 Low-dose pulse cyclophosphamide in interstitial lung disease associated with systemic sclerosis (SSc-ILD) - efficacy of maintenance immunosuppression in responders and non-responders Seminars in Arthritis and Rheumatism, September 30, 2014    Clinical Article

17 Vitamin D deficiency is associated with progression of knee osteoarthritis The Journal of Nutrition, October 10, 2014    Clinical Article

18 Oral bisphosphonate use and total knee/hip implant survival: Validation of results in an external population-based cohort Arthritis & Rheumatism, August 14, 2014    Clinical Article

19 Lipid profile changes in patients with chronic inflammatory arthritis treated with biologics and tofacitinib in randomized clinical trials: A systematic review and meta-analysis Arthritis & Rheumatism, October 14, 2014    Evidence Based Medicine    Review Article

20 Efficacy of a natural mineral complex in North American adults with osteoarthritis of the knee: A randomized double-blind placebo-controlled study Full Text Open Access Rheumatology: Research and Reviews, October 13, 2014    Free full text    Clinical Article

Indexed Journals in Rheumatology: Arthritis & Rheumatism, Annals of Rheumatic Diseases, Journal of Rheumatologymore