Background:Tumor necrosis factor (TNF) inhibitors are important drugs in treating patients with ankylosing spondylitis (AS). However, they are not used as a first-line treatment for AS. There is an insufficient treatment response to the first-line treatment, non-steroidal anti-inflammatory drugs (NSAIDs), in over 40% of patients. If we can predict who will need TNF inhibitors at an earlier phase, adequate treatment can be provided at an appropriate time and potential damages can be avoided. There is no precise predictive model at present. Recently, various machine learning methods show great performances in predictions using clinical data.Objectives:We aim to generate an artificial neural network (ANN) model to predict early TNF inhibitor users in patients with ankylosing spondylitis.Methods:The baseline demographic and laboratory data of patients who visited Samsung Medical Center rheumatology clinic from Dec. 2003 to Sep. 2018 were analyzed. Patients were divided into two groups: early TNF inhibitor users treated by TNF inhibitors within six months of their follow-up (early-TNF users), and the others (non-early-TNF users). Machine learning models were formulated to predict the early-TNF users using the baseline data. Additionally, feature importance analysis was performed to delineate significant baseline characteristics.Results:The numbers of early-TNF and non-early-TNF users were 90 and 509, respectively. The best performing ANN model utilized 3 hidden layers with 50 hidden nodes each; its performance (area under curve (AUC) = 0.75) was superior to logistic regression model, support vector machine, and random forest model (AUC = 0.72, 0.65, and 0.71, respectively) in predicting early-TNF users. Feature importance analysis revealed erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and height as the top significant baseline characteristics for predicting early-TNF users. Among these characteristics, height was revealed by machine learning models but not by conventional statistical techniques.Conclusion:Our model displayed superior performance in predicting early TNF users compared with logistic regression and other machine learning models. Machine learning can be a vital tool in predicting treatment response in various rheumatologic diseases.Disclosure of Interests:None declared
AB0652 MACHINE LEARNING TO PREDICT EARLY TNF INHIBITOR USERS IN PATIENTS WITH ANKYLOSING SPONDYLITIS
