Analysis of the Reasons for DMARD Therapy Discontinuation in Patients with Rheumatoid Arthritis in the Czech and Slovak Republics
Identifieur interne : 000295 ( Istex/Corpus ); précédent : 000294; suivant : 000296Analysis of the Reasons for DMARD Therapy Discontinuation in Patients with Rheumatoid Arthritis in the Czech and Slovak Republics
Auteurs : K. Pavelka ; Š. Forejtová ; A. Pavelková ; J. Zvárová ; J. Rovensk ; A. Tuchy OváSource :
- Clinical Rheumatology [ 0770-3198 ] ; 2002-06-01.
English descriptors
- KwdEn :
Abstract
Abstract:: The aim of the study was to evaluate the efficacy and safety of disease-modifying drugs (DMARDs) in everyday clinical practice in Central European States (the Czech and Slovak republics). This was a retrospective, multicentre study. With the help of a special questionnaire, the medical files of 760 patients in 15 centres were analysed looking for reasons for DMARD discontinuation (e.g. insufficient efficacy, toxicity). The secondary endpoints were duration of therapy with individual DMARDs and the influence of other factors (demographic, disease specific, concomitant therapy) on duration of therapy. In 47.1 % of patients therapy was interrupted because of lack of efficacy, in 43.2 % because of adverse events, and in 9 % for undefined reasons. Toxic reactions leading to withdrawal were most common with gold (62.6 %) and methotrexate (62.5 %). Because of insufficient effect, treatment was most frequently interrupted with antimalarials (62.3 %) and penicillamine (53.2 %), but in only 22% treated with methotrexate. The mean duration of one treatment episode with DMARDs was 28.1 þ 48.9 months. Surprisingly, it was longest for cyclophosphamide (53.5 + 55.1 months) and shortest for cyclosporin (7.0 þ 6.7 months). The mean duration of treatment with methotrexate was only 14.9; þ 16.2 months. The mean duration of treatment with one DMARD was statistically longer in patients with positive rheumatoid factor, extra-articular disease and age lower than 50 years. There was no impact of sex, concomitant steroid treatment and high or low sedimentation rate on treatment duration. Considerable differences in everyday clinical practice with DMARDs between Central European states and published data from the US and western Europe have been found. More education about modern strategies in the treatment of RA is probably necessary for practising rheumatologists.
Url:
DOI: 10.1007/s10067-002-8289-0
Links to Exploration step
ISTEX:B2BA0211CB2708B4125E2413161C327A5AC06991Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Analysis of the Reasons for DMARD Therapy Discontinuation in Patients with Rheumatoid Arthritis in the Czech and Slovak Republics</title><author><name sortKey="Pavelka, K" sort="Pavelka, K" uniqKey="Pavelka K" first="K." last="Pavelka">K. Pavelka</name><affiliation><mods:affiliation>Institute of Rheumatology, Prague; Czech Republic, Czech Republic</mods:affiliation></affiliation></author><author><name sortKey="Forejtova, S" sort="Forejtova, S" uniqKey="Forejtova S" first="Š." last="Forejtová">Š. Forejtová</name><affiliation><mods:affiliation>Institute of Rheumatology, Prague; Czech Republic, Czech Republic</mods:affiliation></affiliation></author><author><name sortKey="Pavelkova, A" sort="Pavelkova, A" uniqKey="Pavelkova A" first="A." last="Pavelková">A. Pavelková</name><affiliation><mods:affiliation>Institute of Rheumatology, Prague; Czech Republic, Czech Republic</mods:affiliation></affiliation></author><author><name sortKey="Zvarova, J" sort="Zvarova, J" uniqKey="Zvarova J" first="J." last="Zvárová">J. Zvárová</name><affiliation><mods:affiliation>European Center for Medical Informatics, Statistics and Epidemiology of Charles University and Academy of Sciences of the Czech Republic, Czech Republic, Czech Republic</mods:affiliation></affiliation></author><author><name sortKey="Rovensk, J" sort="Rovensk, J" uniqKey="Rovensk J" first="J." last="Rovensk">J. Rovensk</name><affiliation><mods:affiliation>Research Institute for Rheumatological Diseases Piešt’any; Slovak Republic, Czech Republic</mods:affiliation></affiliation></author><author><name sortKey="Tuchy Ova, A" sort="Tuchy Ova, A" uniqKey="Tuchy Ova A" first="A." last="Tuchy Ová">A. Tuchy Ová</name><affiliation><mods:affiliation>Research Institute for Rheumatological Diseases Piešt’any; Slovak Republic, Czech Republic</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:B2BA0211CB2708B4125E2413161C327A5AC06991</idno><date when="2002" year="2002">2002</date><idno type="doi">10.1007/s10067-002-8289-0</idno><idno type="url">https://api.istex.fr/ark:/67375/VQC-JT52ZQZQ-T/fulltext.pdf</idno><idno type="wicri:Area/Istex/Corpus">000295</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000295</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Analysis of the Reasons for DMARD Therapy Discontinuation in Patients with Rheumatoid Arthritis in the Czech and Slovak Republics</title><author><name sortKey="Pavelka, K" sort="Pavelka, K" uniqKey="Pavelka K" first="K." last="Pavelka">K. Pavelka</name><affiliation><mods:affiliation>Institute of Rheumatology, Prague; Czech Republic, Czech Republic</mods:affiliation></affiliation></author><author><name sortKey="Forejtova, S" sort="Forejtova, S" uniqKey="Forejtova S" first="Š." last="Forejtová">Š. Forejtová</name><affiliation><mods:affiliation>Institute of Rheumatology, Prague; Czech Republic, Czech Republic</mods:affiliation></affiliation></author><author><name sortKey="Pavelkova, A" sort="Pavelkova, A" uniqKey="Pavelkova A" first="A." last="Pavelková">A. Pavelková</name><affiliation><mods:affiliation>Institute of Rheumatology, Prague; Czech Republic, Czech Republic</mods:affiliation></affiliation></author><author><name sortKey="Zvarova, J" sort="Zvarova, J" uniqKey="Zvarova J" first="J." last="Zvárová">J. Zvárová</name><affiliation><mods:affiliation>European Center for Medical Informatics, Statistics and Epidemiology of Charles University and Academy of Sciences of the Czech Republic, Czech Republic, Czech Republic</mods:affiliation></affiliation></author><author><name sortKey="Rovensk, J" sort="Rovensk, J" uniqKey="Rovensk J" first="J." last="Rovensk">J. Rovensk</name><affiliation><mods:affiliation>Research Institute for Rheumatological Diseases Piešt’any; Slovak Republic, Czech Republic</mods:affiliation></affiliation></author><author><name sortKey="Tuchy Ova, A" sort="Tuchy Ova, A" uniqKey="Tuchy Ova A" first="A." last="Tuchy Ová">A. Tuchy Ová</name><affiliation><mods:affiliation>Research Institute for Rheumatological Diseases Piešt’any; Slovak Republic, Czech Republic</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Clinical Rheumatology</title><title level="j" type="abbrev">Clin Rheumatol</title><idno type="ISSN">0770-3198</idno><idno type="eISSN">1434-9949</idno><imprint><publisher>Springer-Verlag</publisher><pubPlace>London</pubPlace><date type="published" when="2002-06-01">2002-06-01</date><biblScope unit="volume">21</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="220">220</biblScope><biblScope unit="page" to="226">226</biblScope></imprint><idno type="ISSN">0770-3198</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0770-3198</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Key words:Adverse effects – Disease-modifying drugs – DMARDs – Rheumatoid arthritis – Therapy</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Abstract:: The aim of the study was to evaluate the efficacy and safety of disease-modifying drugs (DMARDs) in everyday clinical practice in Central European States (the Czech and Slovak republics). This was a retrospective, multicentre study. With the help of a special questionnaire, the medical files of 760 patients in 15 centres were analysed looking for reasons for DMARD discontinuation (e.g. insufficient efficacy, toxicity). The secondary endpoints were duration of therapy with individual DMARDs and the influence of other factors (demographic, disease specific, concomitant therapy) on duration of therapy. In 47.1 % of patients therapy was interrupted because of lack of efficacy, in 43.2 % because of adverse events, and in 9 % for undefined reasons. Toxic reactions leading to withdrawal were most common with gold (62.6 %) and methotrexate (62.5 %). Because of insufficient effect, treatment was most frequently interrupted with antimalarials (62.3 %) and penicillamine (53.2 %), but in only 22% treated with methotrexate. The mean duration of one treatment episode with DMARDs was 28.1 þ 48.9 months. Surprisingly, it was longest for cyclophosphamide (53.5 + 55.1 months) and shortest for cyclosporin (7.0 þ 6.7 months). The mean duration of treatment with methotrexate was only 14.9; þ 16.2 months. The mean duration of treatment with one DMARD was statistically longer in patients with positive rheumatoid factor, extra-articular disease and age lower than 50 years. There was no impact of sex, concomitant steroid treatment and high or low sedimentation rate on treatment duration. Considerable differences in everyday clinical practice with DMARDs between Central European states and published data from the US and western Europe have been found. More education about modern strategies in the treatment of RA is probably necessary for practising rheumatologists.</div></front></TEI><istex><corpusName>springer-journals</corpusName><author><json:item><name>K. Pavelka</name><affiliations><json:string>Institute of Rheumatology, Prague; Czech Republic, Czech Republic</json:string></affiliations></json:item><json:item><name>Š. Forejtová</name><affiliations><json:string>Institute of Rheumatology, Prague; Czech Republic, Czech Republic</json:string></affiliations></json:item><json:item><name>A. Pavelková</name><affiliations><json:string>Institute of Rheumatology, Prague; Czech Republic, Czech Republic</json:string></affiliations></json:item><json:item><name>J. Zvárová</name><affiliations><json:string>European Center for Medical Informatics, Statistics and Epidemiology of Charles University and Academy of Sciences of the Czech Republic, Czech Republic, Czech Republic</json:string></affiliations></json:item><json:item><name>J. Rovenský</name><affiliations><json:string>Research Institute for Rheumatological Diseases Piešt’any; Slovak Republic, Czech Republic</json:string></affiliations></json:item><json:item><name>A. Tuchyňová</name><affiliations><json:string>Research Institute for Rheumatological Diseases Piešt’any; Slovak Republic, Czech Republic</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Key words:Adverse effects – Disease-modifying drugs – DMARDs – Rheumatoid arthritis – Therapy</value></json:item></subject><articleId><json:string>20210220</json:string><json:string>Art1</json:string></articleId><arkIstex>ark:/67375/VQC-JT52ZQZQ-T</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>OriginalPaper</json:string></originalGenre><abstract>Abstract:: The aim of the study was to evaluate the efficacy and safety of disease-modifying drugs (DMARDs) in everyday clinical practice in Central European States (the Czech and Slovak republics). This was a retrospective, multicentre study. With the help of a special questionnaire, the medical files of 760 patients in 15 centres were analysed looking for reasons for DMARD discontinuation (e.g. insufficient efficacy, toxicity). The secondary endpoints were duration of therapy with individual DMARDs and the influence of other factors (demographic, disease specific, concomitant therapy) on duration of therapy. In 47.1 % of patients therapy was interrupted because of lack of efficacy, in 43.2 % because of adverse events, and in 9 % for undefined reasons. Toxic reactions leading to withdrawal were most common with gold (62.6 %) and methotrexate (62.5 %). Because of insufficient effect, treatment was most frequently interrupted with antimalarials (62.3 %) and penicillamine (53.2 %), but in only 22% treated with methotrexate. The mean duration of one treatment episode with DMARDs was 28.1 þ 48.9 months. Surprisingly, it was longest for cyclophosphamide (53.5 + 55.1 months) and shortest for cyclosporin (7.0 þ 6.7 months). The mean duration of treatment with methotrexate was only 14.9; þ 16.2 months. The mean duration of treatment with one DMARD was statistically longer in patients with positive rheumatoid factor, extra-articular disease and age lower than 50 years. There was no impact of sex, concomitant steroid treatment and high or low sedimentation rate on treatment duration. Considerable differences in everyday clinical practice with DMARDs between Central European states and published data from the US and western Europe have been found. More education about modern strategies in the treatment of RA is probably necessary for practising rheumatologists.</abstract><qualityIndicators><score>8.193</score><pdfWordCount>3193</pdfWordCount><pdfCharCount>22783</pdfCharCount><pdfVersion>1.3</pdfVersion><pdfPageCount>7</pdfPageCount><pdfPageSize>595 x 782 pts</pdfPageSize><refBibsNative>false</refBibsNative><abstractWordCount>284</abstractWordCount><abstractCharCount>1882</abstractCharCount><keywordCount>1</keywordCount></qualityIndicators><title>Analysis of the Reasons for DMARD Therapy Discontinuation in Patients with Rheumatoid Arthritis in the Czech and Slovak Republics</title><genre><json:string>research-article</json:string></genre><host><title>Clinical Rheumatology</title><language><json:string>unknown</json:string></language><publicationDate>2002</publicationDate><copyrightDate>2002</copyrightDate><issn><json:string>0770-3198</json:string></issn><eissn><json:string>1434-9949</json:string></eissn><journalId><json:string>10067</json:string></journalId><volume>21</volume><issue>3</issue><pages><first>220</first><last>226</last></pages><genre><json:string>journal</json:string></genre><subject><json:item><value>Medicine & Public Health</value></json:item><json:item><value>Rheumatology</value></json:item></subject></host><ark><json:string>ark:/67375/VQC-JT52ZQZQ-T</json:string></ark><publicationDate>2002</publicationDate><copyrightDate>2002</copyrightDate><doi><json:string>10.1007/s10067-002-8289-0</json:string></doi><id>B2BA0211CB2708B4125E2413161C327A5AC06991</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/ark:/67375/VQC-JT52ZQZQ-T/fulltext.pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/ark:/67375/VQC-JT52ZQZQ-T/bundle.zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/ark:/67375/VQC-JT52ZQZQ-T/fulltext.tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Analysis of the Reasons for DMARD Therapy Discontinuation in Patients with Rheumatoid Arthritis in the Czech and Slovak Republics</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher scheme="https://scientific-publisher.data.istex.fr">Springer-Verlag</publisher><pubPlace>London</pubPlace><availability><licence><p>Clinical Rheumatology, 2002</p></licence><p scheme="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-3XSW68JL-F">springer</p></availability><date>2002</date></publicationStmt><notesStmt><note type="research-article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</note><note type="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note><note>Original Article</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Analysis of the Reasons for DMARD Therapy Discontinuation in Patients with Rheumatoid Arthritis in the Czech and Slovak Republics</title><author xml:id="author-0000"><persName><forename type="first">K.</forename><surname>Pavelka</surname></persName><affiliation>Institute of Rheumatology, Prague; Czech Republic, Czech Republic</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Š.</forename><surname>Forejtová</surname></persName><affiliation>Institute of Rheumatology, Prague; Czech Republic, Czech Republic</affiliation></author><author xml:id="author-0002"><persName><forename type="first">A.</forename><surname>Pavelková</surname></persName><affiliation>Institute of Rheumatology, Prague; Czech Republic, Czech Republic</affiliation></author><author xml:id="author-0003"><persName><forename type="first">J.</forename><surname>Zvárová</surname></persName><affiliation>European Center for Medical Informatics, Statistics and Epidemiology of Charles University and Academy of Sciences of the Czech Republic, Czech Republic, Czech Republic</affiliation></author><author xml:id="author-0004"><persName><forename type="first">J.</forename><surname>Rovenský</surname></persName><affiliation>Research Institute for Rheumatological Diseases Piešt’any; Slovak Republic, Czech Republic</affiliation></author><author xml:id="author-0005"><persName><forename type="first">A.</forename><surname>Tuchyňová</surname></persName><affiliation>Research Institute for Rheumatological Diseases Piešt’any; Slovak Republic, Czech Republic</affiliation></author><idno type="istex">B2BA0211CB2708B4125E2413161C327A5AC06991</idno><idno type="ark">ark:/67375/VQC-JT52ZQZQ-T</idno><idno type="DOI">10.1007/s10067-002-8289-0</idno><idno type="article-id">20210220</idno><idno type="article-id">Art1</idno></analytic><monogr><title level="j">Clinical Rheumatology</title><title level="j" type="abbrev">Clin Rheumatol</title><idno type="pISSN">0770-3198</idno><idno type="eISSN">1434-9949</idno><idno type="journal-ID">true</idno><idno type="volume-issue-count">6</idno><imprint><publisher>Springer-Verlag</publisher><pubPlace>London</pubPlace><date type="published" when="2002-06-01"></date><biblScope unit="volume">21</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="220">220</biblScope><biblScope unit="page" to="226">226</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2002</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Abstract:: The aim of the study was to evaluate the efficacy and safety of disease-modifying drugs (DMARDs) in everyday clinical practice in Central European States (the Czech and Slovak republics). This was a retrospective, multicentre study. With the help of a special questionnaire, the medical files of 760 patients in 15 centres were analysed looking for reasons for DMARD discontinuation (e.g. insufficient efficacy, toxicity). The secondary endpoints were duration of therapy with individual DMARDs and the influence of other factors (demographic, disease specific, concomitant therapy) on duration of therapy. In 47.1 % of patients therapy was interrupted because of lack of efficacy, in 43.2 % because of adverse events, and in 9 % for undefined reasons. Toxic reactions leading to withdrawal were most common with gold (62.6 %) and methotrexate (62.5 %). Because of insufficient effect, treatment was most frequently interrupted with antimalarials (62.3 %) and penicillamine (53.2 %), but in only 22% treated with methotrexate. The mean duration of one treatment episode with DMARDs was 28.1 þ 48.9 months. Surprisingly, it was longest for cyclophosphamide (53.5 + 55.1 months) and shortest for cyclosporin (7.0 þ 6.7 months). The mean duration of treatment with methotrexate was only 14.9; þ 16.2 months. The mean duration of treatment with one DMARD was statistically longer in patients with positive rheumatoid factor, extra-articular disease and age lower than 50 years. There was no impact of sex, concomitant steroid treatment and high or low sedimentation rate on treatment duration. Considerable differences in everyday clinical practice with DMARDs between Central European states and published data from the US and western Europe have been found. More education about modern strategies in the treatment of RA is probably necessary for practising rheumatologists.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><item><term>Key words:Adverse effects – Disease-modifying drugs – DMARDs – Rheumatoid arthritis – Therapy</term></item></list></keywords></textClass><textClass><keywords scheme="Journal-Subject-Group"><list><label>SCH</label><item><term>Medicine & Public Health</term></item><label>SCH57009</label><item><term>Rheumatology</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2002-06-01">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/VQC-JT52ZQZQ-T/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus springer-journals not found" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//Springer-Verlag//DTD A++ V2.4//EN" URI="http://devel.springer.de/A++/V2.4/DTD/A++V2.4.dtd" name="istex:docType"></istex:docType><istex:document><Publisher><PublisherInfo><PublisherName>Springer-Verlag</PublisherName><PublisherLocation>London</PublisherLocation></PublisherInfo><Journal><JournalInfo JournalProductType="ArchiveJournal" NumberingStyle="Unnumbered"><JournalID>10067</JournalID><JournalPrintISSN>0770-3198</JournalPrintISSN><JournalElectronicISSN>1434-9949</JournalElectronicISSN><JournalTitle>Clinical Rheumatology</JournalTitle><JournalAbbreviatedTitle>Clin Rheumatol</JournalAbbreviatedTitle><JournalSubjectGroup><JournalSubject Code="SCH" Type="Primary">Medicine & Public Health</JournalSubject><JournalSubject Code="SCH57009" Priority="1" Type="Secondary">Rheumatology</JournalSubject></JournalSubjectGroup></JournalInfo><Volume><VolumeInfo TocLevels="0" VolumeType="Regular"><VolumeIDStart>21</VolumeIDStart><VolumeIDEnd>21</VolumeIDEnd><VolumeIssueCount>6</VolumeIssueCount></VolumeInfo><Issue IssueType="Regular"><IssueInfo TocLevels="0"><IssueIDStart>3</IssueIDStart><IssueIDEnd>3</IssueIDEnd><IssueHistory><CoverDate><Year>2002</Year><Month>06</Month></CoverDate></IssueHistory><IssueCopyright><CopyrightHolderName>Clinical Rheumatology</CopyrightHolderName><CopyrightYear>2002</CopyrightYear></IssueCopyright></IssueInfo><Article ID="Art1"><ArticleInfo ArticleType="OriginalPaper" ContainsESM="No" Language="En" NumberingStyle="Unnumbered" TocLevels="0"><ArticleID>20210220</ArticleID><ArticleDOI>10.1007/s10067-002-8289-0</ArticleDOI><ArticleSequenceNumber>8</ArticleSequenceNumber><ArticleTitle Language="En">Analysis of the Reasons for DMARD Therapy Discontinuation in Patients with Rheumatoid Arthritis in the Czech and Slovak Republics</ArticleTitle><ArticleCategory>Original Article</ArticleCategory><ArticleFirstPage>220</ArticleFirstPage><ArticleLastPage>226</ArticleLastPage><ArticleHistory><RegistrationDate><Year>2002</Year><Month>2</Month><Day>7</Day></RegistrationDate><OnlineDate><Year>2014</Year><Month>2</Month><Day>7</Day></OnlineDate></ArticleHistory><ArticleCopyright><CopyrightHolderName>Clinical Rheumatology</CopyrightHolderName><CopyrightYear>2002</CopyrightYear></ArticleCopyright><ArticleGrants Type="Regular"><MetadataGrant Grant="OpenAccess"></MetadataGrant><AbstractGrant Grant="OpenAccess"></AbstractGrant><BodyPDFGrant Grant="Restricted"></BodyPDFGrant><BodyHTMLGrant Grant="Restricted"></BodyHTMLGrant><BibliographyGrant Grant="Restricted"></BibliographyGrant><ESMGrant Grant="Restricted"></ESMGrant></ArticleGrants></ArticleInfo><ArticleHeader><AuthorGroup><Author AffiliationIDS="A1"><AuthorName DisplayOrder="Western"><GivenName>K.</GivenName><FamilyName>Pavelka</FamilyName></AuthorName></Author><Author AffiliationIDS="A1"><AuthorName DisplayOrder="Western"><GivenName>Š.</GivenName><FamilyName>Forejtová</FamilyName></AuthorName></Author><Author AffiliationIDS="A1"><AuthorName DisplayOrder="Western"><GivenName>A.</GivenName><FamilyName>Pavelková</FamilyName></AuthorName></Author><Author AffiliationIDS="A2"><AuthorName DisplayOrder="Western"><GivenName>J.</GivenName><FamilyName>Zvárová</FamilyName></AuthorName></Author><Author AffiliationIDS="A3"><AuthorName DisplayOrder="Western"><GivenName>J.</GivenName><FamilyName>Rovenský</FamilyName></AuthorName></Author><Author AffiliationIDS="A3"><AuthorName DisplayOrder="Western"><GivenName>A.</GivenName><FamilyName>Tuchyňová</FamilyName></AuthorName></Author><Affiliation ID="A1"><OrgName>Institute of Rheumatology, Prague; Czech Republic</OrgName><OrgAddress><Country>Czech Republic</Country></OrgAddress></Affiliation><Affiliation ID="A2"><OrgName>European Center for Medical Informatics, Statistics and Epidemiology of Charles University and Academy of Sciences of the Czech Republic, Czech Republic</OrgName><OrgAddress><Country>Czech Republic</Country></OrgAddress></Affiliation><Affiliation ID="A3"><OrgName>Research Institute for Rheumatological Diseases Piešt’any; Slovak Republic</OrgName><OrgAddress><Country>Czech Republic</Country></OrgAddress></Affiliation></AuthorGroup><Abstract ID="Abs1" Language="En"><Heading>Abstract:</Heading><Para> The aim of the study was to evaluate the efficacy and safety of disease-modifying drugs (DMARDs) in everyday clinical practice in Central European States (the Czech and Slovak republics). This was a retrospective, multicentre study. With the help of a special questionnaire, the medical files of 760 patients in 15 centres were analysed looking for reasons for DMARD discontinuation (e.g. insufficient efficacy, toxicity). The secondary endpoints were duration of therapy with individual DMARDs and the influence of other factors (demographic, disease specific, concomitant therapy) on duration of therapy. In 47.1 % of patients therapy was interrupted because of lack of efficacy, in 43.2 % because of adverse events, and in 9 % for undefined reasons. Toxic reactions leading to withdrawal were most common with gold (62.6 %) and methotrexate (62.5 %). Because of insufficient effect, treatment was most frequently interrupted with antimalarials (62.3 %) and penicillamine (53.2 %), but in only 22% treated with methotrexate. The mean duration of one treatment episode with DMARDs was 28.1 þ 48.9 months. Surprisingly, it was longest for cyclophosphamide (53.5 + 55.1 months) and shortest for cyclosporin (7.0 þ 6.7 months). The mean duration of treatment with methotrexate was only 14.9; þ 16.2 months. The mean duration of treatment with one DMARD was statistically longer in patients with positive rheumatoid factor, extra-articular disease and age lower than 50 years. There was no impact of sex, concomitant steroid treatment and high or low sedimentation rate on treatment duration. Considerable differences in everyday clinical practice with DMARDs between Central European states and published data from the US and western Europe have been found. More education about modern strategies in the treatment of RA is probably necessary for practising rheumatologists.
</Para></Abstract><KeywordGroup Language="En"><Keyword>Key words:Adverse effects – Disease-modifying drugs – DMARDs – Rheumatoid arthritis – Therapy</Keyword></KeywordGroup><ArticleNote Type="Misc"><SimplePara>Received: 31 January 2001 / Accepted: 22 November 2001</SimplePara></ArticleNote></ArticleHeader><NoBody></NoBody></Article></Issue></Volume></Journal></Publisher></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Analysis of the Reasons for DMARD Therapy Discontinuation in Patients with Rheumatoid Arthritis in the Czech and Slovak Republics</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Analysis of the Reasons for DMARD Therapy Discontinuation in Patients with Rheumatoid Arthritis in the Czech and Slovak Republics</title></titleInfo><name type="personal"><namePart type="given">K.</namePart><namePart type="family">Pavelka</namePart><affiliation>Institute of Rheumatology, Prague; Czech Republic, Czech Republic</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Š.</namePart><namePart type="family">Forejtová</namePart><affiliation>Institute of Rheumatology, Prague; Czech Republic, Czech Republic</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">A.</namePart><namePart type="family">Pavelková</namePart><affiliation>Institute of Rheumatology, Prague; Czech Republic, Czech Republic</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J.</namePart><namePart type="family">Zvárová</namePart><affiliation>European Center for Medical Informatics, Statistics and Epidemiology of Charles University and Academy of Sciences of the Czech Republic, Czech Republic, Czech Republic</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J.</namePart><namePart type="family">Rovenský</namePart><affiliation>Research Institute for Rheumatological Diseases Piešt’any; Slovak Republic, Czech Republic</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">A.</namePart><namePart type="family">Tuchyňová</namePart><affiliation>Research Institute for Rheumatological Diseases Piešt’any; Slovak Republic, Czech Republic</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="OriginalPaper" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>Springer-Verlag</publisher><place><placeTerm type="text">London</placeTerm></place><dateIssued encoding="w3cdtf">2002-06-01</dateIssued><copyrightDate encoding="w3cdtf">2002</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><abstract lang="en">Abstract:: The aim of the study was to evaluate the efficacy and safety of disease-modifying drugs (DMARDs) in everyday clinical practice in Central European States (the Czech and Slovak republics). This was a retrospective, multicentre study. With the help of a special questionnaire, the medical files of 760 patients in 15 centres were analysed looking for reasons for DMARD discontinuation (e.g. insufficient efficacy, toxicity). The secondary endpoints were duration of therapy with individual DMARDs and the influence of other factors (demographic, disease specific, concomitant therapy) on duration of therapy. In 47.1 % of patients therapy was interrupted because of lack of efficacy, in 43.2 % because of adverse events, and in 9 % for undefined reasons. Toxic reactions leading to withdrawal were most common with gold (62.6 %) and methotrexate (62.5 %). Because of insufficient effect, treatment was most frequently interrupted with antimalarials (62.3 %) and penicillamine (53.2 %), but in only 22% treated with methotrexate. The mean duration of one treatment episode with DMARDs was 28.1 þ 48.9 months. Surprisingly, it was longest for cyclophosphamide (53.5 + 55.1 months) and shortest for cyclosporin (7.0 þ 6.7 months). The mean duration of treatment with methotrexate was only 14.9; þ 16.2 months. The mean duration of treatment with one DMARD was statistically longer in patients with positive rheumatoid factor, extra-articular disease and age lower than 50 years. There was no impact of sex, concomitant steroid treatment and high or low sedimentation rate on treatment duration. Considerable differences in everyday clinical practice with DMARDs between Central European states and published data from the US and western Europe have been found. More education about modern strategies in the treatment of RA is probably necessary for practising rheumatologists.</abstract><note>Original Article</note><subject lang="en"><topic>Key words:Adverse effects – Disease-modifying drugs – DMARDs – Rheumatoid arthritis – Therapy</topic></subject><relatedItem type="host"><titleInfo><title>Clinical Rheumatology</title></titleInfo><titleInfo type="abbreviated"><title>Clin Rheumatol</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><originInfo><publisher>Springer</publisher><dateIssued encoding="w3cdtf">2002-06-01</dateIssued><copyrightDate encoding="w3cdtf">2002</copyrightDate></originInfo><subject><genre>Journal-Subject-Group</genre><topic authority="SpringerSubjectCodes" authorityURI="SCH">Medicine & Public Health</topic><topic authority="SpringerSubjectCodes" authorityURI="SCH57009">Rheumatology</topic></subject><identifier type="ISSN">0770-3198</identifier><identifier type="eISSN">1434-9949</identifier><identifier type="JournalID">10067</identifier><identifier type="VolumeIssueCount">6</identifier><part><date>2002</date><detail type="volume"><number>21</number><caption>vol.</caption></detail><detail type="issue"><number>3</number><caption>no.</caption></detail><extent unit="pages"><start>220</start><end>226</end></extent></part><recordInfo><recordOrigin>Clinical Rheumatology, 2002</recordOrigin></recordInfo></relatedItem><identifier type="istex">B2BA0211CB2708B4125E2413161C327A5AC06991</identifier><identifier type="ark">ark:/67375/VQC-JT52ZQZQ-T</identifier><identifier type="DOI">10.1007/s10067-002-8289-0</identifier><identifier type="ArticleID">20210220</identifier><identifier type="ArticleID">Art1</identifier><accessCondition type="use and reproduction" contentType="copyright">Clinical Rheumatology, 2002</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-3XSW68JL-F">springer</recordContentSource><recordOrigin>Clinical Rheumatology, 2002</recordOrigin></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/ark:/67375/VQC-JT52ZQZQ-T/record.json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Sante/explor/ChloroquineV1/Data/Istex/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000295 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Istex/Corpus/biblio.hfd -nk 000295 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Sante
|area= ChloroquineV1
|flux= Istex
|étape= Corpus
|type= RBID
|clé= ISTEX:B2BA0211CB2708B4125E2413161C327A5AC06991
|texte= Analysis of the Reasons for DMARD Therapy Discontinuation in Patients with Rheumatoid Arthritis in the Czech and Slovak Republics
}}
| This area was generated with Dilib version V0.6.33. |  |