Response to: 'Correspondence on 'Five-year treat-to-target outcomes after methotrexate induction therapy with or without other csDMARDs and temporary glucocorticoids for rheumatoid arthritis in the CareRA trial by Jain and Dhir et al

We thank Dr Dhir et al for their kind words and would like to address some of the points raised.1 First, in patients without markers of poor prognosis, the COBRA-Slim scheme with methotrexate (MTX) and prednisone bridging led to a more rapid response than initial MTX monotherapy in the first 16 weeks.2 Subsequently, remission rates did not differ until year 5, but patients starting a COBRA-Slim scheme had a lower disease activity and better functionality longitudinally over 5 years.3–5 This long-term effect of prednisone bridging seems counterintuitive to Dr Dhir, given the results of the 'BehandelStrategieën in Reumatoïde Arthritis' (BeSt) study and the 'Treatment of Early Aggressive Rheumatoid Arthritis' (TEAR) trial, showing that long-term outcomes were essentially determined by treating-to-target.6 7 Unfortunately, differences in design and follow-up duration hamper direct comparisons of the Care in...

Source: Annals of the Rheumatic Diseases - June 12, 2023 Category: Rheumatology Authors: Stouten, V., Westhovens, R., Pazmino, S., De Cock, D., Van der Elst, K., Joly, J., Bertrand, D., Verschueren, P. Tags: ARD Correspondence response Source Type: research