Higher doses of methotrexate associated with discontinuation of oral glucocorticoids after initiation of biological DMARDs: A retrospective observational study based on data from a Japanese multicenter registry study
| Autor: | Kenya Terabe, Hisato Ishikawa, Takeshi Oguchi, Yasuhide Kanayama, Naoki Ishiguro, Yutaka Yoshioka, Atsushi Kaneko, Yuji Hirano, Shuji Asai, Hideki Takagi, Masahiro Hanabayashi, Yutaka Yokota, Toshihisa Kojima, Koji Funahashi, Tsuyoshi Nishiume, Seiji Tsuboi, Takayoshi Fujibayashi, Nobunori Takahashi, Takayasu Ito, Mochihito Suzuki, Yasumori Sobue, Yuichiro Yabe |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Registry study Administration Oral Arthritis Rheumatoid 03 medical and health sciences 0302 clinical medicine Japan Rheumatology Internal medicine medicine Humans Registries 030212 general & internal medicine Propensity Score Glucocorticoids Retrospective Studies 030203 arthritis & rheumatology business.industry Retrospective cohort study Middle Aged medicine.disease Discontinuation Methotrexate Treatment Outcome Withholding Treatment Antirheumatic Agents Rheumatoid arthritis Female business hormones hormone substitutes and hormone antagonists Glucocorticoid medicine.drug |
| Zdroj: | Modern Rheumatology. 31:796-802 |
| ISSN: | 1439-7609 1439-7595 |
| Popis: | Glucocorticoids are important drugs used to treat rheumatoid arthritis. We recommend glucocorticoid discontinuation as soon as possible given the associated side-effects, but many patients continue to take oral glucocorticoids long-term. The present study aimed to explore factors associated with glucocorticoid discontinuation at 52 weeks after initiating biological disease-modifying antirheumatic drugs (bDMARDs). Subjects were 564 patients from a Japanese multicenter registry who were administered glucocorticoids and methotrexate (MTX) followed by initiation of the first bDMARD. We examined the status of oral glucocorticoid use at 52 weeks after initiating the first bDMARD. By 52 weeks after bDMARD initiation, 164 patients (29.1%) discontinued glucocorticoids. Multivariable analysis identified age, MTX dose, and glucocorticoid dose as factors independently associated with glucocorticoid discontinuation. After adjusting for baseline characteristics using propensity score matching, among patient groups administered MTX ≤ 8 mg/week and MTX > 8 mg/week, 105 pairs remained. A significantly higher rate of glucocorticoid discontinuation (41.0%) was noted for patients administered MTX > 8 mg/week. Our findings suggest that glucocorticoids may be discontinued after initiating bDMARDs. Moreover, higher MTX doses (>8 mg/week) at the time of bDMARD initiation were associated with glucocorticoid discontinuation among patients treated with bDMARDs. |
| Databáze: | OpenAIRE |
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