Effectiveness of TNF inhibitor treatment with various methotrexate doses in patients with rheumatoid arthritis: results from clinical practice

Objective.To investigate baseline characteristics associated with radiographic progression and the effect of disease activity, drug, switching, and withdrawal on radiographic progression in tumor necrosis factor (TNF) inhibitor-naive patients with rheumatoid arthritis (RA) followed for about 2 years after anti-TNF initiation in clinical practice.Methods.DANBIO-registered patients with RA who had available radiographs (anti-TNF initiation and ∼2 yrs followup) were included. Radiographs were scored, blinded to chronology with the Sharp/van der Heijde method and linked with DANBIO data. Baseline characteristics were investigated with univariate regression and significant variables included in a multivariable logistic regression analysis with ± radiographic progression [Δ total Sharp score (TSS) > 0] as dependent variable. Effect of time-averaged C-reactive protein (CRP), 28-joint Disease Activity Score with CRP (DAS28-CRP), and treatment status at followup were investigated with univariate regression analysis.Results.The study included 930 patients. They were 75% women, 79% positive for IgM-rheumatoid factor (IgM-RF), median age was 57 yrs (range 19–88), disease duration 9 yrs (1–59), DAS28-CRP 5.0 (1.4–7.8), TSS median 15 [3–45 interquartile range (IQR)] and mean 31 (SD 40). Patients started treatment with infliximab (59%), etanercept (18%), or adalimumab (23%). At followup (median 526 days, IQR 392–735), 61% were treated with the initial anti-TNF, 29% had switched TNF inhibitor, and 10% had withdrawn. Twenty-seven percent of patients had progressed radiographically. ΔTSS was median 0.0 [0.0–0.5 IQR/mean 0.6 (SD 2.4)] units/year. Higher TSS, older age, positive IgM-RF, and concomitant prednisolone at baseline were associated with radiographic progression. Time-averaged DAS28-CRP and time-averaged CRP, but not type of TNF inhibitor, were associated with radiographic progression. Patients who stopped/switched during followup progressed more than patients who continued treatment.Conclusion.High TSS, older age, IgM-RF positivity, and concomitant prednisolone were associated with radiographic progression during 2 years of followup of 930 anti-TNF–treated patients with RA in clinical practice. High disease activity and switching/stopping anti-TNF treatment were associated with radiographic progression.

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Multi-biomarker disease activity score as a predictor of disease relapse in patients with rheumatoid arthritis stopping TNF inhibitor treatment

PLoS ONE ◽

10.1371/journal.pone.0192425 ◽

2018 ◽

Vol 13 (5) ◽

pp. e0192425 ◽

Cited By ~ 8

Author(s):

Marjan Ghiti Moghadam ◽

Femke B. G. Lamers-Karnebeek ◽

Harald E. Vonkeman ◽

Peter M. ten Klooster ◽

Janneke Tekstra ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Disease Activity Score ◽

Activity Score ◽

Tnf Inhibitor ◽

Disease Relapse ◽

Inhibitor Treatment

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Pneumocystis jiroveciipneumonia: a rare but serious complication during TNF inhibitor treatment for rheumatoid arthritis in Japan

International Journal of Clinical Rheumatology ◽

10.2217/ijr.13.30 ◽

2013 ◽

Vol 8 (4) ◽

pp. 425-426

Author(s):

Nobuyuki Miyasaka ◽

Masayoshi Harigai

Keyword(s):

Rheumatoid Arthritis ◽

Tnf Inhibitor ◽

Inhibitor Treatment

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Impact of tumour necrosis factor inhibitor treatment on radiographic progression in rheumatoid arthritis patients in clinical practice: results from the nationwide Danish DANBIO registry

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2012-201319 ◽

2012 ◽

Vol 72 (1) ◽

pp. 57-63 ◽

Cited By ~ 23

Author(s):

Lykke Midtbøll Ørnbjerg ◽

Mikkel Østergaard ◽

Pernille Bøyesen ◽

Niels Steen Krogh ◽

Anja Thormann ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Clinical Practice ◽

Tumour Necrosis Factor ◽

Tumour Necrosis ◽

Radiographic Progression ◽

Tumour Necrosis Factor Inhibitor ◽

Factor Inhibitor ◽

Necrosis Factor ◽

Inhibitor Treatment

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Association of the multi-biomarker disease activity score with joint destruction in patients with rheumatoid arthritis receiving tumor necrosis factor-alpha inhibitor treatment in clinical practice

Modern Rheumatology ◽

10.3109/14397595.2016.1153449 ◽

2016 ◽

Vol 26 (6) ◽

pp. 850-856 ◽

Cited By ~ 8

Author(s):

Shintaro Hirata ◽

Wanying Li ◽

Satoshi Kubo ◽

Shunsuke Fukuyo ◽

Yasushi Mizuno ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Clinical Practice ◽

Tumor Necrosis Factor ◽

Tumor Necrosis ◽

Disease Activity Score ◽

Joint Destruction ◽

Necrosis Factor Alpha ◽

Factor Alpha ◽

Necrosis Factor ◽

Inhibitor Treatment

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SAT0079 Tumour Necrosis Factor Alpha Inhibitor Treatment Normalises Hand Bone Loss in a Minority of Rheumatoid Arthritis Patients Treated in Clinical Practice. Results from the Copenhagen Osteoarthritis Study and the Danbio Registry

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2015-eular.1789 ◽

2015 ◽

Vol 74 (Suppl 2) ◽

pp. 677.1-677

Author(s):

L. Ørnbjerg ◽

M. Østergaard ◽

T. Jensen ◽

L. Hyldstrup ◽

P. Bach-Mortensen ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Clinical Practice ◽

Bone Loss ◽

Tumour Necrosis Factor ◽

Tumour Necrosis ◽

Tumour Necrosis Factor Alpha ◽

Necrosis Factor Alpha ◽

Factor Alpha ◽

Necrosis Factor ◽

Inhibitor Treatment

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SAT0097 DO COMORBIDITIES IMPACT PERSISTENCE OF FIRST TUMOR NECROSIS FACTOR INHIBITOR TREATMENT IN RHEUMATOID ARTHRITIS? DATA FROM TURKBIO

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.1599 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 982.1-982

Author(s):

T. Yüce İnel ◽

S. B. Kocaer ◽

Y. Erez ◽

S. Gulle ◽

A. Karakas ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Survival Rate ◽

Tumor Necrosis Factor Inhibitor ◽

Inhibitor Therapy ◽

Response To Treatment ◽

Treatment Quality ◽

Tnf Inhibitor ◽

Increased Risk ◽

The Impact ◽

Inhibitor Treatment

Background:Studies indicate that patients with rheumatoid arthritis (RA) are at increased risk of developing several comorbid disorders. Comorbidities affect treatment decisions, the effectiveness of the treatment, quality of life, RA prognosis, and survival rate [1].Objectives:The aim of thisstudyto investigate the impact of comorbidity on the first TNF inhibitor treatment persistence in RA.Methods:In the TURKBIO database, patients with an ICD 10-diagnosis of RA (M05 or M06) who started TNF inhibitor therapy between January 2011 and June 2019 were enrolled. Demographic and clinical characteristics, acute phase reactants, disease activity scores (DAS 28 CRP, HAQ, CDAI, VAS global), initial comorbidities and numbers, drug persistence, were evaluated. Kaplan-Meier plots and Cox proportional hazard regression analyses were performed.Results:A total of 1172 patients >18 years of age treated with TNF-α inhibitors were included in the study. The most prevalent comorbidities were: hypertension in 262 patients (32.6%), obesity in 254 (32.6%), osteoporosis in 178 (22.3%), chronic lung disease in 143 (17.9%) and depression in 126 (15.8%). The baseline characteristics are summarised in Table 1. The presence of comorbidity did not affect the survival rate of the first TNF inhibitor therapy in the RA patients (p: 0.65). Comorbidities had no effect on DAS28 CRP (> 1.2 reduction) responses at 6 and 12 months of treatment (p: 0.18, p: 0.83, respectively). As the mean disease duration increases, the persistence of the first TNF inhibitor decreases by 5%.Conclusion:This study demonstrated the increasing burden of comorbidities in RA. However, it suggested that the presence and number of comorbidities did not influence the rate of persistence in the first TNF inhibitor drug and the response to treatment.References:[1] Gabriel, S.E. and K. Michaud,Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases.Arthritis research & therapy, 2009.11(3): p. 229.Disclosure of Interests:None declared

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