In the era of disease-modifying antirheumatic drugs, how close are we to treating rheumatoid arthritis without the use of glucocorticoids?

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dc.authorid0000-0003-1185-5816
dc.authorid0000-0002-6725-4182
dc.authorid0000-0002-2260-4660
dc.authorid0000-0002-8084-2018
dc.authorscopusid57203458191
dc.authorscopusid55646165400
dc.authorscopusid13205593600
dc.authorscopusid6506739457
dc.authorscopusid7004353906
dc.authorscopusid16679897800
dc.authorscopusid14422446100
dc.authorwosidKanıtez, Nilüfer Alpay/W-7332-2019
dc.authorwosidkaratas, ahmet/E-7046-2016
dc.authorwosidErtenli, Ihsan/AAV-7175-2021
dc.authorwosidBilgin, Emre/C-8092-2015
dc.contributor.authorYağız, Burcu
dc.contributor.authorCoşkun, Belkıs Nihan
dc.contributor.authorPehlivan, Yavuz
dc.contributor.authorDalkılıç, Ediz
dc.contributor.authorKiraz, Sedat
dc.contributor.authorYazısız, Veli
dc.contributor.authorKalyoncu, Umut
dc.contributor.authorMercan, Rıdvan
dc.date.accessioned2022-05-11T14:40:01Z
dc.date.available2022-05-11T14:40:01Z
dc.date.issued2021
dc.departmentFakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalı
dc.description.abstractWe wanted to see how close we could get to our goal of treating rheumatoid arthritis (RA) without the use of glucocorticoids (GCs) in the disease-modifying antirheumatic drugs (DMARDs) era using real-life data. Established in 2017, the TReasure database is a web-based, prospective, observational cohort for Turkey. As of May 2019, there were 2,690 RA patients recorded as receiving biologic and targeted synthetic DMARDs (bDMARDs and tsDMARDs) therapy. At the start of the bDMARDs or tsDMARDs, patients with follow-up visits of at least 3 months were registered. At the time of registration and the last visit, doses of GCs were recorded and it was determined if the target dose of <= 7.5 mg was achieved. During registration and follow-up, 23.4% of the patients did not receive GCs and 76.5% of the patients received GCs at any time. GCs could be stopped after 59 (25-116) months in 28.4% of these patients, but 71.6% of patients were still using GC. The target GC dose could not be achieved in 18.2% of these patients (n = 352). The rate of continuing to use GC was significantly higher in women, in the elderly, those with rheumatoid factor (RF) positive, with higher Visual Analog Scale (VAS) pain and Disease Activity Score (DAS)-28. The initial GC dose of >= 7.5 mg/day was found to be crucial in not reaching the GC target dose (p < 0.001, OR 39.0 (24.1-63.2)). The initial GC dose of >= 7.5 mg/day, female gender, age, RF positivity, high DAS28, and VAS pain level were all highly related for GC continuation. Despite the use of DMARDs, our data revealed that we are still far from achieving our goal of treating RA without using steroids.
dc.description.sponsorshipHacettepe Rheumatology Association (HRD); Hacettepe Financial Enterprises
dc.description.sponsorshipHacettepe Rheumatology Association (HRD) and Hacettepe Financial Enterprises.
dc.identifier.doi10.1007/s00296-021-04939-8
dc.identifier.endpage1924
dc.identifier.issn0172-8172
dc.identifier.issn1437-160X
dc.identifier.issue11en_US
dc.identifier.pmid34226947
dc.identifier.scopus2-s2.0-85109266667
dc.identifier.scopusqualityQ2
dc.identifier.startpage1915
dc.identifier.urihttps://doi.org/10.1007/s00296-021-04939-8
dc.identifier.urihttps://hdl.handle.net/20.500.11776/8835
dc.identifier.volume41
dc.identifier.wosWOS:000669781300001
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorMercan, Rıdvan
dc.language.isoen
dc.publisherSpringer Heidelberg
dc.relation.ispartofRheumatology International
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectDMARDs
dc.subjectGlucocorticoids
dc.subjectRheumatoid arthritis
dc.subjectTarget dose
dc.subjectTReasure
dc.subjectDose Prednisone Therapy
dc.subjectEular Recommendations
dc.subjectDouble-Blind
dc.subjectManagement
dc.titleIn the era of disease-modifying antirheumatic drugs, how close are we to treating rheumatoid arthritis without the use of glucocorticoids?
dc.typeArticle

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