6/28/23, 12:02 AM CAMERA Pathway Feedback Search Clinical Topics Home Studies CAMERA CAMERA Disease Rheumatoid arthritis Trial question What is the effect of intensive treatment with methotrexate in patients with early rheumatoid arthritis? Study design Multi-center Open label RCT Population Characteristics of study participants 67.0% female N = 299 33.0% male 299 patients (201 female, 98 male) Inclusion criteria: patients with early rheumatoid arthritis Key exclusion criteria: previous use of corticosteroids or any DMARD, use of cytotoxic or immunosuppressive drugs within a period of three months before inclusion, alcohol abuse (> 2 units per day), and psychological problems Interventions N=151 intensive methotrexate adjustment (tailored to the individual patient on the basis of predefined response criteria with monthly outpatient visits) N=148 conventional methotrexate adjustment (according to common practice, outpatient visit once every 3 months) Primary outcome Percentage of patients achieving at least one remission at 2 years https://web.pathway.md/studies/rectsU3AiQI6NUVRd 1/2 6/28/23, 12:02 AM CAMERA Pathway 50.0 % 50 37.5 % 37 25.0 % Significant increase 12.5 % NNT = 8 0.0 % Intensive methotrexate adjustment Conventional methotrexate adjustment Significant increase in the percentage of patients achieving at least one remission at 2 years (50% vs. 37%; RR 1.35, 95% CI 0.14 to 2.56) Secondary outcomes Significant decrease in time to remission (10.4 months vs. 14.3 months; ARD -3.9, 95% CI -6.21 to -1.59) Significant decrease in morning stiffness (17 vs. 23.7; MD -6.7, 95% CI -11.73 to -1.67) Significant decrease in tender joint count (3.6 vs. 5.5; MD -1.9, 95% CI -3.03 to -0.77) Safety outcomes No significant differences in adverse events, including gastrointestinal (24.6% vs. 25.2%), neurological disorders (18.8% vs. 18.8%), renal events (2.4% vs. 2.8%). Conclusion In patients with early rheumatoid arthritis, intensive methotrexate adjustment was superior to conventional methotrexate adjustment with respect to the percentage of patients achieving at least one remission at 2 years. Reference Verstappen SM, Jacobs JW, van der Veen MJ et al. Intensive treatment with methotrexate in early rheumatoid arthritis: aiming for remission. Computer Assisted Management in Early Rheumatoid Arthritis (CAMERA, an open-label strategy trial). Ann Rheum Dis. 2007 Nov;66(11):1443-9. Open reference URL https://web.pathway.md/studies/rectsU3AiQI6NUVRd 2/2