Drug‐induced toxicity and patient reported outcomes in rheumatoid arthritis patients following intensive treated‐to‐target strategy: does ceasing therapy due to toxicity worsen outcomes in long term?

摘要: Summary Aim While the introduction of treat-to-target (T2T) strategy has been an important advance in management rheumatoid arthritis (RA), potential for increased toxicity due to use concurrent drugs could adversely affect patient reported outcomes (PROs). The objective was determine whether cessation therapy affects long-term improvement PROs patients treated according T2T strategy. Methods A total 149 from inception cohort early RA were included. occurrence and severity monitored at each visit over 3 years. studied function (measured using health assessment questionnaire); pain, fatigue global (PtGA) all assessed a 100 mm visual analogue scale; helplessness health-related quality life (HRQoL). For PRO, effect drug withdrawal measured by comparing mean change among with no/temporary vs. permanent withdrawal. In addition, effects frequency withdrawals, weeks number withdrawn analysed linear regression. Result After years, 56 (37.4%) ceased least one permanently toxicity. Patients (n = 93) achieved significantly greater (mean −0.54 −0.31, p 0.033), pain −39.82 −5.02, 0.018), −29.14 −14.76, 0.015) PtGA −29.64 −17.00, 0.018) compared their counterparts. Higher withdrawals associated lesser improvements function, PtGA, while had effects. However, did not have significant association HRQoL helplessness. Conclusion Improvements years diminished who broader measures affected.