RESEARCH - Most rheumatologists are conservative in active RA despite MTX therapy: PRISME survey

June 28, 2006

J Rheumatol. 2006 Jun 15; [Epub ahead of print]

Most Rheumatologists Are Conservative in Active Rheumatoid Arthritis Despite

Methotrexate Therapy: Results of the PRISME Survey.

Saraux A, Devauchelle-Pensec V, Engerran L, Flipo RM.

OBJECTIVE: To evaluate the proportion of patients with rheumatoid arthritis

(RA) visiting office-based rheumatologists for persistently active RA

despite past or current methotrexate (MTX) treatment, and to describe the

management of these patients in France in 2003. METHODS: All French

rheumatologists were invited to participate in a cross-sectional postal

survey. During a predetermined week, they were to include the first 2

patients seen for RA with a history of past or current MTX treatment.

Adequacy of current treatment was assessed based on the 28-joint Disease

Activity Score 28 (DAS28) and on current MTX and corticosteroid regimens.

RESULTS: Of the 1800 French rheumatologists, 492 returned 838 assessable

patient questionnaires. Mean patient age was 58 years and mean time since RA

diagnosis was 10 years; 77% of patients were currently taking MTX, and 51% a

corticosteroid. High dosages were noted for MTX (> 15 mg/week) in 20% of

patients and for corticosteroid therapy (> 10 mg/day) in 5%. Nevertheless,

41% of patients had active RA (DAS28 score 3.2 to 5.1) and 7% had very

active RA (DAS28 score > 5.1). The treatment was left unchanged in 78% of

patients, and biological therapy was contemplated in only 16% of patients.

CONCLUSION: Although half of MTX-treated patients with RA visiting

office-based rheumatologists had active or very active disease, a change in

treatment was rarely considered.

PMID: 16783865

6783865

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

s Hopkins Medicine

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