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  • Miller, HeatherKarolinska Institute (author)

Mortality over 14 years in MTX-refractory patients randomized to a strategy of addition of infliximab or sulfasalazine and hydroxychloroquine

  • Article/chapterEnglish2021

Publisher, publication year, extent ...

  • 2020-11-12
  • Oxford University Press (OUP),2021
  • 6 s.

Numbers

  • LIBRIS-ID:oai:lup.lub.lu.se:a11a8d7f-00c6-4005-8af4-754eba1dea5f
  • https://lup.lub.lu.se/record/a11a8d7f-00c6-4005-8af4-754eba1dea5fURI
  • https://doi.org/10.1093/rheumatology/keaa553DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:149835919URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • Objective: To compare mortality risk over up to 14 years of follow-up in methotrexate-refractory patients with early RA randomized to a strategy starting with addition of infliximab vs addition of SSZ and HCQ. Methods: Data was from the two-arm, parallel, randomized, active-controlled, open-label Swefot trial in which patients with early RA (symptom duration <1 y) were recruited from 15 rheumatology clinics in Sweden (2002-2005). Patients who did not achieve low disease activity after 3-4 months of MTX were randomized to addition of infliximab (n = 128) or SSZ and HCQ (n = 130). Participants were followed until death, emigration, or end of follow-up, whichever came first. Analyses were by intention-to-treat. Results: Over an average follow-up of 13 years, there were 13 and 16 deaths, respectively [8.8 vs 10.6 deaths per 1000 person-years; mortality hazard ratio 1.2 (95% CI: 0.6, 2.5); P =0.62]. The 1-year mortality was 0.8% in both treatment arms, the 5-year mortality was 2.3% for the infliximab arm compared with 1.5% for the conventional combination treatment arm, while the 10-year mortality was 7.8% and 7.7%, respectively. After 5 years, ∼50% of patients in the conventional combination therapy arm had switched to biologic treatment, and 50% in the biologic arm had discontinued treatment with a biologic DMARD. Conclusion: No difference in mortality risk could be observed over up to 14 years of follow-up between treatment strategy groups. At 5 years (3 years after trial cessation), 50% of patients remained on their assigned therapy, reflecting that DMARD combination is an adequate treatment strategy in 50% of patients.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Wallman, Johan K.Lund University,Lunds universitet,Lund Arthritis Research Group (LARG),Forskargrupper vid Lunds universitet,Lund University Research Groups(Swepub:lu)med-jnk (author)
  • Petersson, Ingemar F.Lund University,Lunds universitet,Lund OsteoArthritis Division - Clinical Epidemiology Unit,Forskargrupper vid Lunds universitet,Tillämpad epidemiologi,Lund University Research Groups,Applied epidemiology,Skåne University Hospital(Swepub:lu)ort-ipe (author)
  • Saevarsdottir, SaedisKarolinska Institutet,Karolinska Institute,University of Iceland (author)
  • Söderling, JonasKarolinska Institute (author)
  • Ernestam, SofiaKarolinska Institute,Akademiskt specialistcentrum, Stockholm (author)
  • Askling, JohanKarolinska Institutet,Karolinska Institute (author)
  • Van Vollenhoven, RonaldUniversity of Amsterdam (author)
  • Neovius, MartinKarolinska Institutet,Karolinska Institute (author)
  • Karolinska InstituteLund Arthritis Research Group (LARG) (creator_code:org_t)

Related titles

  • In:Rheumatology (United Kingdom): Oxford University Press (OUP)60:5, s. 2217-22221462-03241462-0332

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