Predictors of response to anti-TNF therapy in RA patients with moderate or high DAS28 scores

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 5 years of treatment with anti-TNF agents and divided into two groups on the basis of their baseline DAS28 scores (m...

Full description

Saved in:
Bibliographic Details
Published in:Joint, bone, spine : revue du rhumatisme bone, spine : revue du rhumatisme, 2014-01, Vol.81 (1), p.37-40
Main Authors: Atzeni, Fabiola, Bongiovanni, Sara, Marchesoni, Antonio, Filippini, Matteo, Caporali, Roberto, Gorla, Roberto, Cavagna, Lorenzo, Favalli, Ennio Giulio, Saccardo, Francesco, Sarzi-Puttini, Piercarlo
Format: Article
Language:English
Subjects:
Adult
Aged
Anti-TNF
Antirheumatic Agents - therapeutic use
Arthritis, Rheumatoid - drug therapy
DAS28 scores
Female
High and moderate disease activity
Humans
Internal Medicine
Male
Middle Aged
Predictive factors
Prognosis
Registries
Rheumatology
Severity of Illness Index
Treatment Outcome
Tumor Necrosis Factor-alpha - antagonists & inhibitors
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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 5 years 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 12 months 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.
ISSN:1297-319X
1778-7254
DOI:10.1016/j.jbspin.2013.04.005