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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
- Source :
- Modern Rheumatology. 31:796-802
- Publication Year :
- 2021
- Publisher :
- Oxford University Press (OUP), 2021.
-
Abstract
- 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.
- Subjects :
- 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
Subjects
Details
- ISSN :
- 14397609 and 14397595
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- Modern Rheumatology
- Accession number :
- edsair.doi.dedup.....0b91bf0bacb627273aa91422bb9e222b