Table 1

Characteristics of patients in ESPOIR cohort included in this study of MTX use at baseline (n=288)

CharacteristicOptimal MTX dose*
Non-optimal MTX dose (n=212)p
Age (years)44.5±12.650.3±11.30.0008
Female sex, n (%)56 (73.7%)163 (76.9%)0.57
Symptom duration (months)†8.8±9.77.7±9.20.20
Smoking31 (40.8%)104 (49.1%)0.22
C-reactive protein level‡28.2±46.821.0±29.50.02
Rheumatoid factor positivity, n (%)‡49 (64.5%)131 (61.8%)0.68
Anti-CCP2 antibodies positivity, n (%)‡48 (63.2%)116 (54.7%)0.20
Erosions present24 (33.3%)92 (45.1%)0.82
SHS score5.9±8.35.7±7.30.75
1987 ACR criteria57 (75%)190 (89.6%)0.0017
Use of corticosteroids in the first year§10 (13.5%)34 (16.2%)0.58
Use of corticosteroids during the second year¶4 (5.71%)33 (17.01%)0.0255
Combination with synthetic DMARDs19 (25%)22 (10.4%)0.0035
Use of biological DMARDs
  During the first year9 (11.8%)16 (7.6%)0.25
  During the first 2 years11 (14.5%)30 (14.2%)0.95
MTX dose
  At initiation (mg/week)14.90±4.4811.18±3.12<0.0001
  At 6 months (mg/week)15.09±4.4211.68±3.13<0.0001
  Escalation between 6 and 12 months11 (14.47%)52 (24.53%)0.069
  Folic acid supplementation at 6 months48 (63.16%)104 (49.06%)0.0346
  • Data are mean±SD or n (%). Significant results are in bold type.

  • *Optimal MTX dose defined as fulfilling the following three criteria: (1) MTX introduction during the first 3 months after inclusion in the ESPOIR cohort; (2) initial dosage ≥10 mg/week; and (3) achieving ≥20 mg/week or 0.3 mg/kg/week MTX with DAS28 >2.6 at 6 months (or any dose with DAS28 <2.6 at 6 months).

  • †Symptom duration defined from the appearance of the first fixed swollen joint.

  • ‡Baseline C-reactive protein level (normal <10 mg/L); IgM and IgA rheumatoid factor (ELISA, Menarini, France; positive >9 UI/mL) and anti-CCP2 antibodies (ELISA, DiaSorin, France; positive >50 U/mL) were detected in all patients by using the same technique in a central lab (Paris-Bichat).

  • §At least 7.5 mg/day equivalent prednisone for more than 3 months in the first year.

  • ¶At least 7.5 mg/day equivalent prednisone for more than 3 months in the second year.

  • ACR, American College of Rheumatology; DAS28, Disease Activity Score in 28 joints; DMARD, disease-modifying antirheumatic drugs; HAQ, Health Assessment Questionnaire; MTX, methotrexate; SHS, Sharp/van der Heijde score; SJC, swollen joint count; TJC, tender joint count.