Comparing outcomes of patients with early active rheumatoid arthritis initially treated on an inpatient or outpatient basis: a posthoc analysis of the CORRA trial
Objective Treatment strategies of patients with active rheumatoid arthritis (RA) vary within and between countries. While most patients in Germany are treated on an outpatient basis, some are hospitalised (inpatients). In the recently published randomised CORRA (CORRA, CORticoid bridging in Rheumato...
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BMJ Publishing Group
2024-12-01
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| Series: | RMD Open |
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| author | Jürgen Braun Renate Klaassen-Mielke Dietmar Krause Anna Mai Nina Timmesfeld Katharina Meiszl |
| author_facet | Jürgen Braun Renate Klaassen-Mielke Dietmar Krause Anna Mai Nina Timmesfeld Katharina Meiszl |
| author_sort | Jürgen Braun |
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| description | Objective Treatment strategies of patients with active rheumatoid arthritis (RA) vary within and between countries. While most patients in Germany are treated on an outpatient basis, some are hospitalised (inpatients). In the recently published randomised CORRA (CORRA, CORticoid bridging in Rheumatoid Arthritis) trial, we studied two 12 week glucocorticoid (GC) bridging strategies in patients with early RA comparing high or low GC doses with placebo, followed by an extension phase of 9 months. Here, in this posthoc analysis, we compared 12 week outcomes of patients according to their initial treatment as inpatients or outpatients.Methods Inpatients initially spent 2–5 days (short-term) or 14 days (long-term) in one tertiary rheumatology hospital. Outpatients were mostly treated in rheumatology practices. There was no randomisation regarding the initial treatment strategy. The main endpoint of this posthoc analysis was Clinical Disease Activity Index (CDAI) remission at weeks 4, 8 and 12.Results Data of 280 outpatients and 95 inpatients could be analysed. Inpatients were more often male, had less cardiovascular comorbidity, but higher baseline CDAI scores and more symptoms of depression compared with outpatients. At weeks 8 and 12, CDAI remission was more frequently observed in inpatients (week 8: 24.7 vs 14.9%; week 12: 30.5 vs 17.3%). These results were confirmed in a multivariable model: OR=2.43 (1.06; 5.55); p=0.035, and OR=2.91 (1.37; 6.14); p=0.005, respectively.Conclusion In early active RA, initial inpatient treatment was associated with higher CDAI remission rates at weeks 8 and 12. This may be due to the initially more intense hospital care. |
| format | Article |
| id | doaj-art-5d76e7361bad4672a4a06de8b328ae4d |
| institution | OA Journals |
| issn | 2056-5933 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMJ Publishing Group |
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| series | RMD Open |
| spelling | doaj-art-5d76e7361bad4672a4a06de8b328ae4d2025-08-20T01:56:46ZengBMJ Publishing GroupRMD Open2056-59332024-12-0110410.1136/rmdopen-2024-004430Comparing outcomes of patients with early active rheumatoid arthritis initially treated on an inpatient or outpatient basis: a posthoc analysis of the CORRA trialJürgen Braun0Renate Klaassen-Mielke1Dietmar Krause2Anna Mai3Nina Timmesfeld4Katharina Meiszl5Rheumatologisches Versorgungszentrum Steglitz, Berlin, GermanyDepartment of Medical Informatics, Biometry and Epidemiology, Ruhr University, Bochum, GermanyDepartment of Medical Informatics, Biometry and Epidemiology, Ruhr University Bochum, Bochum, Germany8 Department of Medical Informatics, Biometry and Epidemiology, Ruhr University Bochum, Bochum, GermanyDepartment of Medical Informatics, Biometry and Epidemiology, Ruhr University Bochum, Bochum, GermanyDepartment of Medical Informatics, Biometry and Epidemiology, Ruhr University Bochum, Bochum, GermanyObjective Treatment strategies of patients with active rheumatoid arthritis (RA) vary within and between countries. While most patients in Germany are treated on an outpatient basis, some are hospitalised (inpatients). In the recently published randomised CORRA (CORRA, CORticoid bridging in Rheumatoid Arthritis) trial, we studied two 12 week glucocorticoid (GC) bridging strategies in patients with early RA comparing high or low GC doses with placebo, followed by an extension phase of 9 months. Here, in this posthoc analysis, we compared 12 week outcomes of patients according to their initial treatment as inpatients or outpatients.Methods Inpatients initially spent 2–5 days (short-term) or 14 days (long-term) in one tertiary rheumatology hospital. Outpatients were mostly treated in rheumatology practices. There was no randomisation regarding the initial treatment strategy. The main endpoint of this posthoc analysis was Clinical Disease Activity Index (CDAI) remission at weeks 4, 8 and 12.Results Data of 280 outpatients and 95 inpatients could be analysed. Inpatients were more often male, had less cardiovascular comorbidity, but higher baseline CDAI scores and more symptoms of depression compared with outpatients. At weeks 8 and 12, CDAI remission was more frequently observed in inpatients (week 8: 24.7 vs 14.9%; week 12: 30.5 vs 17.3%). These results were confirmed in a multivariable model: OR=2.43 (1.06; 5.55); p=0.035, and OR=2.91 (1.37; 6.14); p=0.005, respectively.Conclusion In early active RA, initial inpatient treatment was associated with higher CDAI remission rates at weeks 8 and 12. This may be due to the initially more intense hospital care.https://rmdopen.bmj.com/content/10/4/e004430.full |
| spellingShingle | Jürgen Braun Renate Klaassen-Mielke Dietmar Krause Anna Mai Nina Timmesfeld Katharina Meiszl Comparing outcomes of patients with early active rheumatoid arthritis initially treated on an inpatient or outpatient basis: a posthoc analysis of the CORRA trial RMD Open |
| title | Comparing outcomes of patients with early active rheumatoid arthritis initially treated on an inpatient or outpatient basis: a posthoc analysis of the CORRA trial |
| title_full | Comparing outcomes of patients with early active rheumatoid arthritis initially treated on an inpatient or outpatient basis: a posthoc analysis of the CORRA trial |
| title_fullStr | Comparing outcomes of patients with early active rheumatoid arthritis initially treated on an inpatient or outpatient basis: a posthoc analysis of the CORRA trial |
| title_full_unstemmed | Comparing outcomes of patients with early active rheumatoid arthritis initially treated on an inpatient or outpatient basis: a posthoc analysis of the CORRA trial |
| title_short | Comparing outcomes of patients with early active rheumatoid arthritis initially treated on an inpatient or outpatient basis: a posthoc analysis of the CORRA trial |
| title_sort | comparing outcomes of patients with early active rheumatoid arthritis initially treated on an inpatient or outpatient basis a posthoc analysis of the corra trial |
| url | https://rmdopen.bmj.com/content/10/4/e004430.full |
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