Leiden University Scholarly Publications

Persistent URL of this record https://hdl.handle.net/1887/108699

In Collections

This item can be found in the following collections:

Visser, K.; Goekoop-Ruiterman, Y.P.M.; Vries-Bouwstra, J.K. de; Ronday, H.K.; Seys, P.E.H.; Kerstens, P.J.S.M.; ... ; Allaart, C.F. (2010)

A matrix risk model for the prediction of rapid radiographic progression in patients with rheumatoid arthritis receiving different dynamic treatment strategies: post hoc analyses from the BeSt study

Article / Letter to editor
Objectives To develop a matrix model for the prediction of rapid radiographic progression (RRP) in subpopulations of patients with recent-onset rheumatoid arthritis (RA) receiving different dynamic treatment strategies. Methods Data from 465 patients with recent-onset RA randomised to receive initial monotherapy or combination therapy were used. Predictors for RRP (increase in Sharp-van der Heijde score >= 5 after 1 year) were identified by multivariate logistic regression analysis. For subpopulations, the estimated risk of RRP per treatment group and the number needed to treat (NNT) were visualised in a matrix. Results The presence of autoantibodies, baseline C-reactive protein (CRP) level, erosion score and treatment group were significant independent predictors of RRP in the matrix. Combination therapy was associated with a markedly reduced risk of RRP. The positive and negative predictive values of the matrix were 62% and 91%, respectively. The NNT with initial combination...Show moreObjectives To develop a matrix model for the prediction of rapid radiographic progression (RRP) in subpopulations of patients with recent-onset rheumatoid arthritis (RA) receiving different dynamic treatment strategies. Methods Data from 465 patients with recent-onset RA randomised to receive initial monotherapy or combination therapy were used. Predictors for RRP (increase in Sharp-van der Heijde score >= 5 after 1 year) were identified by multivariate logistic regression analysis. For subpopulations, the estimated risk of RRP per treatment group and the number needed to treat (NNT) were visualised in a matrix. Results The presence of autoantibodies, baseline C-reactive protein (CRP) level, erosion score and treatment group were significant independent predictors of RRP in the matrix. Combination therapy was associated with a markedly reduced risk of RRP. The positive and negative predictive values of the matrix were 62% and 91%, respectively. The NNT with initial combination therapy to prevent one patient from RRP with monotherapy was in the range 2-3, 3-7 and 7-25 for patients with a high, intermediate and low predicted risk, respectively. Conclusion The matrix model visualises the risk of RRP for subpopulations of patients with recent-onset RA if treated dynamically with initial monotherapy or combination therapy. Rheumatologists might use the matrix for weighing their initial treatment choice.Show less
smallest detectable difference cyclic citrullinated peptide joint damage combination therapy prognostic-factors clinical-practice disease trial methotrexate antibodies
All authors
Visser, K.; Goekoop-Ruiterman, Y.P.M.; Vries-Bouwstra, J.K. de; Ronday, H.K.; Seys, P.E.H.; Kerstens, P.J.S.M.; Huizinga, T.W.J.; Dijkmans, B.A.C.; Allaart, C.F.
Date
2010-07-31
Journal
Annals of the Rheumatic Diseases
Volume
69
Issue
7
Pages
1333 - 1337
DOI
doi:10.1136/ard.2009.121160