Good clinical response, remission, and predictors of remission in rheumatoid arthritis patients treated with tumor necrosis factor-α blockers: The GISEA study

Luana Mancarella, Francesca Bobbio-Pallavicini, Fulvia Ceccarelli, Paola Chiara Falappone, Angelo Ferrante, Domenico Malesci, Alfonso Massara, Francesca Nacci, Maria Elena Secchi, Stefania Manganelli, Fausto Salaffi, Maria Lisa Bambara, Stefano Bombardieri, Maurizio Cutolo, Clodoveo Ferri, Mauro Galeazzi, Roberto Gerli, Roberto Giacomelli, Walter Grassi, Giovanni LapadulaMarco Matucci Cerinic, Carlomaurizio Montecucco, Francesco Trotta, Giovanni Triolo, Gabriele Valentini, Guido Valesini, Gianfranco F. Ferraccioli

Research output: Contribution to journalArticle

Abstract

Objective. To assess the prevalence of good clinical response and remission in rheumatoid arthritis (RA) patients with longstanding disease treated with anti-tumor necrosis factor-α (TNF-α) drugs at outpatient clinics. Methods. Retrospective national study of 14 academic tertiary referral rheumatology medical centers. RA patients with a Disease Activity Score (DAS28) > 3.2 were defined as having active disease and could start TNF-α blockers. All patients received one TNF-α blocker plus methotrexate (10-20 mg/wk). At the third month the patients were categorized as responders or nonresponders, based on improvement of at least 0.25 of the Health Assessment Questionnaire (HAQ). Those who had improved by at least 0.25 HAQ were analyzed for possible predictors of DAS28 remission at the sixth month. Results. A total of 1257 patients started TNF-α blockers. Of these, 591 (46.7%) reached the sixth month with an improvement of HAQ of 0.25 at the third month. In the cohort of patients reaching HAQ of 0.25, DAS28 remission was seen in 24% of rheumatoid factor (RF)-positive and 36% of RF-negative patients (p = 0.03). Logistic regression analysis for predictors of remission identified age at baseline, HAQ <1.63, and RF negativity as positive predictors of remission at 6 months along with sex (male). Conclusion. We show that only a minority of patients with longstanding RA achieve a good clinical response or remission at the outpatient community level. Predictors of remission identify characteristics commonly observed in subsets with less severe RA.

Original languageEnglish
Pages (from-to)1670-1673
Number of pages4
JournalJournal of Rheumatology
Volume34
Issue number8
Publication statusPublished - Aug 2007

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Keywords

  • Disability score
  • Good clinical response
  • Remission
  • Rheumatoid arthritis
  • Tumor necrosis factor-α blockers

ASJC Scopus subject areas

  • Rheumatology
  • Immunology

Cite this

Mancarella, L., Bobbio-Pallavicini, F., Ceccarelli, F., Falappone, P. C., Ferrante, A., Malesci, D., Massara, A., Nacci, F., Secchi, M. E., Manganelli, S., Salaffi, F., Bambara, M. L., Bombardieri, S., Cutolo, M., Ferri, C., Galeazzi, M., Gerli, R., Giacomelli, R., Grassi, W., ... Ferraccioli, G. F. (2007). Good clinical response, remission, and predictors of remission in rheumatoid arthritis patients treated with tumor necrosis factor-α blockers: The GISEA study. Journal of Rheumatology, 34(8), 1670-1673.