Comment on: Assessments of the unmet need in the management of patients with rheumatoid arthritis: analyses from the NOR-DMARD registry: reply

Sir, We thank Drs Kaltsonoudis and Pelechas and Profs Voulgari and Drosos for their interest in our article [1]. In our study, we concluded that there exists a substantial unmet treatment and management need for patients with RA. The support for this conclusion was our analyses on data from the Norwegian DMARD (NOR-DMARD) registry. In their comment, Kaltsonoudiset al. [2] challenge our conclusion with a reference to their own research. In the study by Kaltsonoudiset al., patients were registered in the early stages of RA (disease duration<1 year) and treated according to ACR guidelines and EULAR recommendations using all available conventional synthetic (cs) and biologic (b) DMARDs. The patients were then followed for up to 12 years, with treatment response assessed at each visit. The final data set consisted of 517 patients, all of whom had started treatment with csDMARDs. Of these, 324 patients remained on csDMARD treatment, whereas 175 patients were considered inadequate responders to csDMARDs and switched to bDMARDs. Eleven patients continued on csDMARDs despite inadequate response, and 31 of the patients who switched to bDMARDs never achieved an adequate response (low disease activity; LDA). While the authors report that 20.9% of the participants never achieved LDA, should not this number be 8.1% ([31 + 11]/517 × 100%)? Regardless, we commend the authors on the high proportion of patients reaching LDA in their study.
Source: Rheumatology - Category: Rheumatology Source Type: research