Short summary

Methotrexate is the first-line treatment given for rheumatoid arthritis. Recent studies show an inferior treatment response to methotrexate, is associated to the number of comorbid conditions of the patient. In addition, the adherence for methotrexate is often below 50%. To explore this issue, there will be performed a retrospective study. The aim is to investigate if side effects and treatment response to methotrexate is associated to comorbidity in early diagnosed rheumatoid arthritis. Side effects will be reviewed through medical records, and Charlson comorbidity index will be calculated through OPED and CPAS registers. 

Rationale

Rheumatoid arthritis is an autoimmune disease that primarily affects synovial joints. The first-line of treatment is methotrexate, used to prevent joint wreckage. If treatment is maintained the first year, mortality is reduced by 70%. Despite the positive aspects of methotrexate treatment, the adherence is often below 50%. Studies show an inferior treatment response is associated to the number of comorbid conditions of the patient.

It is unclear whether side-effects and treatment response to methotrexate is associated to comorbidity in early-diagnosed rheumatoid arthritis. The aim is to investigate if side effects and treatment response to methotrexate is associated to comorbidity in early diagnosed rheumatoid arthritis.

Side effects will be reviewed through medical records, and Charlson comorbidity index will be calculated through OPED and CPAS registers. 

Description of the cohort

Medical records of patients diagnosed with rheumatoid arthritis are collected from three centers: Department of Reumatology, Odense University Hospital (OUH), Diagnostic Center in Svendborg and Reumaklinik Fyn. Time period: 1/1-2010 to 14/11-2015.

Patients placed in the Region of Southern Denmark is reviewed in OPEN and CPAS, prescription information is used as supplying information. 

Data and biological material

The following information will be collected from medical records: demographics, disease activity and characteristics and side effects. Data from REDCap will be extracted, and combined with register data. A logistic regression model with treatment response and side effects as dependent variables will be developed, analysis will be performed in STATA. 

Collaborating researchers and departments

Department of Clinical Pharmacology, University of Southern Denmark

• Professor Jesper Hallas

Department of Reumatology, Odense University Hospital

• Associate professor Inger Marie Jensen Hansen
• Professor Torkell Ellingensen, PhD

Reumaklinik Fyn

• Cand.med. Palle Ahlquist