RT Book, Section
A1 Huppert, Laura A.
A1 Dyster, Timothy G.
SR Print(0)
ID 1189914068
T1 Key Clinical Trials & Publications in Rheumatology
T2 Huppert’s Notes: Pathophysiology and Clinical Pearls for Internal Medicine
YR 2021
FD 2021
PB McGraw Hill
PP New York, NY
SN 9781260470079
LK accessmedicine.mhmedical.com/content.aspx?aid=1189914068
RD 2024/09/10
AB Methotrexate  and  mortality  in  patients  with  rheumatoid  arthritis:  a  prospective  study.  Lancet  2002;359:1173–7.-  Prospective  observational  study  that  demonstrated  a  60%  decrease  in  all-cause  mortality  and  a  70%  decrease  in  cardiovascular  mortality  among  adults  with  RA  treated  with  methotrexate  compared  to  other  DMARDS  or  prednisone.  Decreased  all-cause  and  CV  mortality  was  not  seen  for  sulfasalazine  or  hydroxychloroquine.  This  study  underscores  the  notion  that  systemic  inflammation  in  RA  contributes  to  cardiovascular  mortality  and  that  methotrexate  ameliorates  this.The  Tight  COntrol  for  Rheumatoid  Arthritis  (TICORA)  Study.  Lancet  2004;364:263–269.-  Single-blind  randomized  controlled  trial  evaluating  monthly  visits  with  DMARD  titration  (MTX,  SSZ,  HCQ)  to  a  goal  disease  activity  score  <2.4  versus  q3  mo  visits  with  titration  per  usual  care.  Patients  in  the  “intensive  management”  group  had  higher  rates  of  remission  (65%  vs.  16%)  at  18  months.  This  study  supported  a  “treat-to-target”  approach  using  a  disease  activity  score  (DAS28  in  this  case)  to  guide  therapy  escalation.