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Article Summary
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Hider SL et al. - Routine clinical and laboratory factors could not predict outcome of treatment with Methotrexate (MTX). Methods- Aim was to examine whether clinical and genetic variables could be used to predict response to MTX
- Pts with inflammatory polyarthritis on MTX as their first DMARD within 3 mos of their baseline visit and who had >= 2 yr f/u data
- Outcome on MTX was defined as (a) stopped for AEs (b) stopped for inefficacy or 2nd DMARD added (c) stopped for other reasons or d) remained on MTX monotherapy
- Variables predicting the reason for stopping monotherapy for inefficacy or AE were established
Results- At 1 yr (2 yrs), 34 (46) pts had stopped for AEs and 25 (49) had either stopped monotherapy for inefficacy or had a 2nd DMARD added
- 231 (188) pts remained on MTX monotherapy
- The strongest predictor of inefficacy at both time points was shared epitope positivity
- High HAQ score and female gender were associated with AEs on MTX at one year
- However even the most optimal combinations of the factors analysed were only weakly predictive of treatment outcome
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