Fabiola Atzeni1, Sara Bongiovanni2, Antonio Marchesoni3, Matteo Filippini4, Roberto Caporali5, Roberto Gorla4, Lorenzo Cavagna5, Ennio Giulio Favalli3, Francesco Saccardo6, Piercarlo Sarzi-Puttini2. 1. Rheumatology Unit, L.Sacco University Hospital of Milan, Milan, Italy. Electronic address: atzenifabiola@hotmail.com. 2. Rheumatology Unit, L.Sacco University Hospital of Milan, Milan, Italy. 3. Day Hospital of Rheumatology, G. Pini Orthopedic Institute, Chair of Rheumatology in Milan, Milan, Italy. 4. Rheumatology and Immunology Unit, Spedali Civili di Brescia, Brescia, Italy. 5. Chair of Rheumatology, IRCCS Policlinico S. Matteo, Pavia, Italy. 6. Internal Medicine, Ospedale di Saronno, A.O. Busto Arsizio, Saronno, Italy.
Abstract
OBJECTIVES: To identify the clinical factors predicting a good clinical response to anti-TNF therapy in rheumatoid arthritis (RA) patients entered in the LORHEN registry after 5years of treatment with anti-TNF agents and divided into two groups on the basis of their baseline DAS28 scores (moderate>3.2-5.1 [MDA] and high>5.1 [HDA]). METHODS: Disease activity at baseline and after 12months was assessed using the DAS28, and response was evaluated using the EULAR improvement criteria. RESULTS: The study involved 1300 patients with established RA: 975 with HDA and 325 with MDA. After a mean 36-month, 29.6% of the patients had a DAS28 score of less or equal to 2.6 (HDA 25.8% vs. MDA 43.0%; P<0.001) and were considered to be in remission. A higher probability of a good EULAR response in patients with HDA was associated with male gender (F vs. M - OR 0.45, 95% CI 0.26-0.78; P: 0.004), lower age at the start of treatment (OR 0.98, 95% CI 0.96-0.99; P: 0.002), the absence of comorbidities (OR 0.18, 95% CI 0.06-0.52; P: 0.002) or no previous use of corticosteroids (OR 1.92, 95% CI 1.14-3.22; P: 0.015) and the use of adalimumab vs. infliximab (OR 2.21, 95% CI 1.37-3.57; P 0.001); in patients with MDA, the probability of a good EULAR response was associated with male gender (F vs. M - OR 0.39, 95% CI 0.17-0.90; P: 0.027). CONCLUSIONS: With the exception of male gender, the factors predicting a good EULAR response are different in patients with MDA and those with HDA.
OBJECTIVES: To identify the clinical factors predicting a good clinical response to anti-TNF therapy in rheumatoid arthritis (RA) patients entered in the LORHEN registry after 5years of treatment with anti-TNF agents and divided into two groups on the basis of their baseline DAS28 scores (moderate>3.2-5.1 [MDA] and high>5.1 [HDA]). METHODS: Disease activity at baseline and after 12months was assessed using the DAS28, and response was evaluated using the EULAR improvement criteria. RESULTS: The study involved 1300 patients with established RA: 975 with HDA and 325 with MDA. After a mean 36-month, 29.6% of the patients had a DAS28 score of less or equal to 2.6 (HDA 25.8% vs. MDA 43.0%; P<0.001) and were considered to be in remission. A higher probability of a good EULAR response in patients with HDA was associated with male gender (F vs. M - OR 0.45, 95% CI 0.26-0.78; P: 0.004), lower age at the start of treatment (OR 0.98, 95% CI 0.96-0.99; P: 0.002), the absence of comorbidities (OR 0.18, 95% CI 0.06-0.52; P: 0.002) or no previous use of corticosteroids (OR 1.92, 95% CI 1.14-3.22; P: 0.015) and the use of adalimumab vs. infliximab (OR 2.21, 95% CI 1.37-3.57; P 0.001); in patients with MDA, the probability of a good EULAR response was associated with male gender (F vs. M - OR 0.39, 95% CI 0.17-0.90; P: 0.027). CONCLUSIONS: With the exception of male gender, the factors predicting a good EULAR response are different in patients with MDA and those with HDA.
Authors: Lianne Kearsley-Fleet; Flora McErlane; Helen E Foster; Mark Lunt; Kath D Watson; Deborah P M Symmons; Kimme L Hyrich Journal: RMD Open Date: 2016-10-07
Authors: James Bluett; Catharine Morgan; Layla Thurston; Darren Plant; Kimme L Hyrich; Ann W Morgan; Anthony G Wilson; John D Isaacs; Lis Cordingley; Anne Barton Journal: Rheumatology (Oxford) Date: 2014-09-10 Impact factor: 7.580