OBJECTIVE: To identify the clinical factors predicting failure or a good clinical response in the cohort of RA patients entered in the Lombardy Rheumatology Network (LORHEN) registry after 3 years of treatment with anti-TNF agents. METHODS: We studied the patients who had received anti-TNF agents and been followed up for a minimum of 6 months. Disease activity at baseline and after 6 months was assessed using the DAS28, and response was evaluated according to the EULAR improvement criteria. RESULTS: 1005 patients (55.72 years) were included in the analysis. at baseline the DAS-28 was 5.91+/-0.95 and a HAQ score was 1.46+/-0.61. At mean of 14.57 months, 29.9% of the patients achieved a DAS-28 of <or=2.6 (remission). A higher RR for remission was associated with male gender (AHR 1.51, 95% CI 1.14-2.00; p: 0.004) and a lower RR for remission with: prior treatment with >3 DMARDs (AHR 0.077, 95% CI 0.58-1.03; p: 0.074), a high ESR (AHR 0.86, 95% CI 0.81-0.92; p: 0.000), Steinbrocker's functional class III/IV (AHR 0.66, 95% CI 0.48-0.90; p: 0.010), a high TJC (AHR 0.97, 95% CI 0.94-0.99; p: 0.011). A 12-month EULAR non-response was observed in 153/821 (18.6%) associated with a higher baseline HAQ score (AOR 1.51, 95% CI 1.03-2.20, p: 0.033), prior treatment with >3 DMARDs (AOR 1.76, 95% CI 1.09-2.85; p: 0.021) and corticosteroid >5 mg/day (AOR 2.05, 95% CI 1.06-3.97; p: 0.034). CONCLUSION: We found that only a minority of patients with long-standing RA treated with anti-TNF agents achieve a good clinical response or remission.
OBJECTIVE: To identify the clinical factors predicting failure or a good clinical response in the cohort of RApatients entered in the Lombardy Rheumatology Network (LORHEN) registry after 3 years of treatment with anti-TNF agents. METHODS: We studied the patients who had received anti-TNF agents and been followed up for a minimum of 6 months. Disease activity at baseline and after 6 months was assessed using the DAS28, and response was evaluated according to the EULAR improvement criteria. RESULTS: 1005 patients (55.72 years) were included in the analysis. at baseline the DAS-28 was 5.91+/-0.95 and a HAQ score was 1.46+/-0.61. At mean of 14.57 months, 29.9% of the patients achieved a DAS-28 of <or=2.6 (remission). A higher RR for remission was associated with male gender (AHR 1.51, 95% CI 1.14-2.00; p: 0.004) and a lower RR for remission with: prior treatment with >3 DMARDs (AHR 0.077, 95% CI 0.58-1.03; p: 0.074), a high ESR (AHR 0.86, 95% CI 0.81-0.92; p: 0.000), Steinbrocker's functional class III/IV (AHR 0.66, 95% CI 0.48-0.90; p: 0.010), a high TJC (AHR 0.97, 95% CI 0.94-0.99; p: 0.011). A 12-month EULAR non-response was observed in 153/821 (18.6%) associated with a higher baseline HAQ score (AOR 1.51, 95% CI 1.03-2.20, p: 0.033), prior treatment with >3 DMARDs (AOR 1.76, 95% CI 1.09-2.85; p: 0.021) and corticosteroid >5 mg/day (AOR 2.05, 95% CI 1.06-3.97; p: 0.034). CONCLUSION: We found that only a minority of patients with long-standing RA treated with anti-TNF agents achieve a good clinical response or remission.
Authors: Maša Umiċeviċ Mirkov; Jing Cui; Sita H Vermeulen; Eli A Stahl; Erik J M Toonen; Remco R Makkinje; Annette T Lee; Tom W J Huizinga; Renee Allaart; Anne Barton; Xavier Mariette; Corinne Richard Miceli; Lindsey A Criswell; Paul P Tak; Niek de Vries; Saedis Saevarsdottir; Leonid Padyukov; S Louis Bridges; Dirk-Jan van Schaardenburg; Tim L Jansen; Ellen A J Dutmer; Mart A F J van de Laar; Pilar Barrera; Timothy R D J Radstake; Piet L C M van Riel; Hans Scheffer; Barbara Franke; Han G Brunner; Robert M Plenge; Peter K Gregersen; Henk-Jan Guchelaar; Marieke J H Coenen Journal: Ann Rheum Dis Date: 2012-12-11 Impact factor: 19.103
Authors: Ruediger B Mueller; Nazim Reshiti; Toni Kaegi; Axel Finckh; Sarah R Haile; Hendrik Schulze-Koops; Michael Schiff; Michael Spaeth; Johannes von Kempis Journal: Clin Rheumatol Date: 2016-11-12 Impact factor: 2.980
Authors: Suzanne Arends; Elisabeth Brouwer; Eveline van der Veer; Henk Groen; Martha K Leijsma; Pieternella M Houtman; Tim L Th A Jansen; Cees G M Kallenberg; Anneke Spoorenberg Journal: Arthritis Res Ther Date: 2011-06-20 Impact factor: 5.156