title: Effect of adherence to European treatment recommendations on early arthritis outcome: data from the ESPOIR cohort.
abstract: OBJECTIVE
  To assess the association of adherence to the 2007 recommendations of the European League Against Rheumatism (EULAR) for managing early arthritis and radiographic progression and disability in patients
  
  
  METHODS
  The authors conducted a prospective population-based cohort study. The ESPOIR cohort was a French cohort of 813 patients with early arthritis not receiving disease-modifying antirheumatic drugs (DMARDs). Adherence to the 2007 EULAR recommendations was defined by measuring adherence to three of the recommendations concerning the initiation and early adjustment of DMARDs. The study endpoints were radiographic progression, defined as the presence of at least one new erosion between baseline and 1 year, and disability as a heath assessment questionnaire score ≥1 at 2 years. A propensity score of being treated according to the recommendations was developed.
  
  
  RESULTS
  After adjustment for propensity score, treatment centre and the main confounding factors, patients without recommendation adherence were at increased risk of radiographic progression at 1 year, and of functional impairment at 2 years (OR 1.98, (95% CI: 1.08 to 3.62 and OR: 2.36, (95% CI: 1.17 to 4.67), respectively).
  
  
  CONCLUSIONS
  Early arthritis patients whose treatment adhered to the 2007 EULAR recommendations seemed to benefit from such treatment in terms of risk of clinical and radiographic progression. Using a propensity score of being treated according to recommendations in observational studies may be useful in assessing the potential impact of these recommendations on outcome.
authors.affiliation: INSERM U738, Paris, France
authors.forename: Cécile
authors.initials: C
authors.lastname: Escalas
authors.forename: Marie
authors.initials: M
authors.lastname: Dalichampt
authors.forename: Bernard
authors.initials: B
authors.lastname: Combe
authors.forename: Bruno
authors.initials: B
authors.lastname: Fautrel
authors.forename: Francis
authors.initials: F
authors.lastname: Guillemin
authors.forename: Pierre
authors.initials: P
authors.lastname: Durieux
authors.forename: Maxime
authors.initials: M
authors.lastname: Dougados
authors.forename: Philippe
authors.initials: P
authors.lastname: Ravaud
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001168:Arthritis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D001175:Arthrography; D018450:Disease Progression; D005260:Female; D006801:Humans; D007596:Joints / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D017410:Practice Guidelines as Topic; D011379:Prognosis; D057216:Propensity Score; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents