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 language | English |
|---|---|
| Pages (from-to) | 1670-1673 |
| Number of pages | 4 |
| Journal | Journal of Rheumatology |
| Volume | 34 |
| Issue number | 8 |
| Publication status | Published - 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
Good clinical response, remission, and predictors of remission in rheumatoid arthritis patients treated with tumor necrosis factor-α blockers : The GISEA study. / Mancarella, Luana; Bobbio-Pallavicini, Francesca; Ceccarelli, Fulvia; Falappone, Paola Chiara; Ferrante, Angelo; Malesci, Domenico; Massara, Alfonso; Nacci, Francesca; Secchi, Maria Elena; Manganelli, Stefania; Salaffi, Fausto; Bambara, Maria Lisa; Bombardieri, Stefano; Cutolo, Maurizio; Ferri, Clodoveo; Galeazzi, Mauro; Gerli, Roberto; Giacomelli, Roberto; Grassi, Walter; Lapadula, Giovanni; Cerinic, Marco Matucci; Montecucco, Carlomaurizio; Trotta, Francesco; Triolo, Giovanni; Valentini, Gabriele; Valesini, Guido; Ferraccioli, Gianfranco F.
In: Journal of Rheumatology, Vol. 34, No. 8, 08.2007, p. 1670-1673.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Good clinical response, remission, and predictors of remission in rheumatoid arthritis patients treated with tumor necrosis factor-α blockers
T2 - The GISEA study
AU - Mancarella, Luana
AU - Bobbio-Pallavicini, Francesca
AU - Ceccarelli, Fulvia
AU - Falappone, Paola Chiara
AU - Ferrante, Angelo
AU - Malesci, Domenico
AU - Massara, Alfonso
AU - Nacci, Francesca
AU - Secchi, Maria Elena
AU - Manganelli, Stefania
AU - Salaffi, Fausto
AU - Bambara, Maria Lisa
AU - Bombardieri, Stefano
AU - Cutolo, Maurizio
AU - Ferri, Clodoveo
AU - Galeazzi, Mauro
AU - Gerli, Roberto
AU - Giacomelli, Roberto
AU - Grassi, Walter
AU - Lapadula, Giovanni
AU - Cerinic, Marco Matucci
AU - Montecucco, Carlomaurizio
AU - Trotta, Francesco
AU - Triolo, Giovanni
AU - Valentini, Gabriele
AU - Valesini, Guido
AU - Ferraccioli, Gianfranco F.
PY - 2007/8
Y1 - 2007/8
N2 - 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.
AB - 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.
KW - Disability score
KW - Good clinical response
KW - Remission
KW - Rheumatoid arthritis
KW - Tumor necrosis factor-α blockers
UR - http://www.scopus.com/inward/record.url?scp=34547939157&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34547939157&partnerID=8YFLogxK
M3 - Article
C2 - 17611987
AN - SCOPUS:34547939157
VL - 34
SP - 1670
EP - 1673
JO - Journal of Rheumatology
JF - Journal of Rheumatology
SN - 0315-162X
IS - 8
ER -