scholarly journals Serum chemerin levels: A potential biomarker of joint inflammation in women with rheumatoid arthritis

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0255854
Author(s):  
Fabiola Gonzalez-Ponce ◽  
Jorge I. Gamez-Nava ◽  
Emilio E. Perez-Guerrero ◽  
Ana M. Saldaña-Cruz ◽  
Maria L. Vazquez-Villegas ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Disease Activity ◽  
Multiple Regression Analysis ◽  
Multiple Regression ◽  
Logistic Regression Analysis ◽  
Fat Mass ◽  
Severe Disease ◽  
Potential Biomarker

Background Chemerin has a potential role in perpetuating inflammation in autoimmune diseases. Nevertheless, to date, there is no conclusive information on whether high chemerin levels increase the severity of rheumatoid arthritis (RA). Therefore, this study evaluated whether serum chemerin is a biomarker of disease activity in RA patients. Methods Study design: cross-sectional. The assessment included clinical and laboratory characteristics, body mass index (BMI) and fat mass. The severity of the disease activity was identified according to the DAS28-CRP index as follows: A) RA with a DAS28-CRP≤2.9 (remission/mild activity) and B) RA with a DAS28-CRP>2.9 (moderate/severe activity). Serum chemerin concentrations were measured by ELISA, and ≥103 ng/mL was considered a high level. Logistic regression analysis was applied to determine whether high chemerin levels were associated with disease activity in RA after adjusting for confounders. Multiple regression analysis was performed to identify variables associated with chemerin levels. Results Of 210 RA patients, 89 (42%) subjects had moderate/severe disease activity and had higher serum chemerin levels than patients with low disease activity or remission (86 ± 34 vs 73± 27; p = 0.003). Serum chemerin correlated with the number of swollen joints (r = 0.15; p = 0.03), DAS28-CRP (r = 0.22; p = 0.002), and C-reactive protein levels (r = 0.14; p = 0.04), but no correlation was observed with BMI and fat mass. In the adjusted logistic regression analysis, high chemerin levels (≥103 ng/mL) were associated with an increased risk of moderate/severe disease activity (OR: 2.76, 95% CI 1.35–5.62; p = 0.005). In the multiple regression analysis, after adjusting for potential confounders, serum chemerin levels were associated with higher DAS28-CRP (p = 0.002). Conclusions Higher chemerin levels increased the risk of moderate and severe disease activity in RA. These results support the role of chemerin as a marker of inflammation in RA. Follow-up studies will identify if maintaining low chemerin levels can be used as a therapeutic target.

scholarly journals POS0455 EFFECT OF ANTI-Ro/SSA ANTIBODIES FOR TREATMENT RESPONSE TO METHOTREXATE IN RHEUMATOID ARTHRITIS: A RETROSPECTIVE MULTICENTER OBSERVATIONAL STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 458.1-458
Author(s):  
R. Yokochi ◽  
H. Tamai ◽  
T. Kido ◽  
Y. Yagyu ◽  
D. Waki ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Disease Activity ◽  
Clinical Response ◽  
Logistic Regression Analysis ◽  
Age At Onset ◽  
Treat To Target ◽  
Low Disease Activity ◽  
Target Strategy

Background:Several previous observational studies have suggested that patients with anti-Ro/SSA antibody-positive rheumatoid arthritis (RA) may respond poorly to treatment, including tumor necrosis factor inhibitors1. However, its influence on methotrexate (MTX) treatment, which is the anchor drug of treat-to-target strategy in RA treatment, remains unclear.Objectives:We compared the clinical response to MTX in both anti-Ro/SSA antibody-positive and -negative patients with MTX-naiive RA and investigated the reasons for the difference in response.Methods:We recruited 210 consecutive patients with RA who were newly started on MTX in this retrospective cohort study. The effect of the presence of anti-Ro/SSA antibodies on achieving low disease activity (LDA) of DAS28-CRP at six months after initiating MTX was investigated by using logistic regression analysis. CDAI, SDAI, concomitant using DMARDs and painkillers, patient’s and evaluator’s VAS, tender joint counts, and swollen joint counts at six months were also compared between the anti-Ro/SSA-positive patients and -negative patients. Missing data were imputed by using multiple imputations before multivariate analysis.Results:32 anti-Ro/SSA antibody-positive patients and 178 anti-Ro/SSA antibody-negative patients were included. The rate of achieving DAS28-LDA at six months was significantly lower in the anti-Ro/SSA antibody-positive patients than those in the anti-Ro/SSA antibody-negative patients (56.2% versus 75.8%, P=0.03). in the logistic regression analysis, the presence of anti-Ro/SSA antibodies was an independent negative predictor for achieving DAS-28-LDA at six months (OR:0.431, 95%CI: 0.190-0.978, P=0.044) (Table1). Anti-Ro/SSA antibody-positive patients had significantly higher patient’s VAS at six months (median [IQR]: 22 [15-41] vs 19 [5-30], P=0.038), and prescribed NSAIDs (37.5% vs 18.0%, P=0.018). CDAI and SDAI after six months were not significantly different between the group.Conclusion:The presence of anti-Ro/SSA antibodies might be one of the predictive factors for the insufficient response to treat to target strategy in RA treatment. Residual pain was suspected as one of the mechanisms contributing to the lesser clinical response of MTX in anti-Ro antibody-positive RA.References:[1]Ran Matsudaira wt al. J Rheumatol 2011;38(11):2346-54Table 1.Logistic regression analysis for the rate of achieving DAS28 low disease activity at six months.Risk factor Odds ratio95%CIP valueAge at onset0.9930.968-1.0180.586Sex (woman)0.6430.300-1.3840.258RF-positive1.9620.853-4.5110.112ACPA-positive0.5520.225-1.3510.192Anti-Ro/SSA antibody-positive0.4310.190-0.9780.044Disclosure of Interests:None declared

scholarly journals AB0212 FLARE RISK AFTER DISCONTINUING LONG-TERM METHOTREXATE TREATMENT IN PATIENTS HAVING RHEUMATOID ARTHRITIS WITH LOW DISEASE ACTIVITY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1406.1-1407
Author(s):  
S. H. Nam ◽  
J. S. Lee ◽  
S. J. Choi ◽  
W. J. Seo ◽  
J. S. Oh ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Disease Activity ◽  
Logistic Regression Analysis ◽  
Weekly Dose ◽  
Low Disease Activity ◽  
Disease Flare ◽  
The Mean

Background:Several recent studies have reported that MTX could be discontinued in patients with low disease activity who are taking biologic DMARDs or tofacitinib. However, there are limited studies on whether MTX could be discontinued in patients with low disease activity who have taken MTX for a long term.Objectives:We investigated the disease flare rate in patients with rheumatoid arthritis (RA) who achieved low disease activity following long-term methotrexate (MTX) treatment and the factors related to flare.Methods:This retrospective longitudinal cohort study included patients with RA and low disease activity who were exposed to MTX for >10 years. Disease flare was defined as an increase in DAS28 of >1.2 within 6 months of discontinuation of MTX. Logistic regression analysis was performed to identify the factors associated with flare.Results:In total, 97 patients with RA were included in the study. The mean baseline DAS28 was 1.96 ± 0.56. The median cumulative MTX dose was 11.7g; the median duration of exposure to MTX was 19 years. Following MTX discontinuation, flare occurred in 43 (44.3%) patients; the mean time to flare was 98 ± 37.7 days. According to univariable logistic regression analysis, C-reactive protein, erythrocyte sedimentation rate (ESR) at discontinuation, the average ESR in the 6 months before discontinuation of MTX, a weekly dose of MTX before discontinuation, and use of other conventional synthetic DMARDs were associated with a higher risk of disease flare. In multivariable analysis, a weekly dose of MTX before discontinuation (OR, 1.014; 95% CI, 1.014–1.342; p = 0.031) was significantly associated with flare risk.Conclusion:Among patients with RA who achieved low disease activity with long-term treatment with MTX, more than half of the patients remained flare free after MTX discontinuation. A higher MTX dose before discontinuation was associated with a high flare risk.Disclosure of Interests:None declared

scholarly journals High Disease Activity Influences the Presence of Vertebral Fractures in Rheumatoid Arthritis

2021 ◽  
Author(s):  
Hideo Sakane ◽  
Koichi Okamura ◽  
Yoichi Iizuka ◽  
Akira Honda ◽  
Eiji Takasawa ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Disease Activity ◽  
Logistic Regression Analysis ◽  
Vertebral Fractures ◽  
Disease Activity Score ◽  
High Disease Activity ◽  
X Ray ◽  
History Of

Abstract Background: To investigate the prevalence and risk factors for vertebral fractures in patients with rheumatoid arthritis (RA) during an era of tight management.Methods: We retrospectively reviewed 426 RA patients who had visited our outpatient RA clinic between July 2017 and June 2020. Among them, we included 107 patients (19 males and 88 females) who had undergone lateral X-ray of the thoracolumbar spine and dual-energy X-ray absorption spectroscopy for the assessment of osteoporosis. We assessed the disease activity score for 28 joints (DAS28), the history of medication for RA and osteoporosis, the number and location of vertebral fractures, and the bone mineral density (BMD). Two board-certified specialists determined osteoporotic vertebral fractures on a lateral X-ray of the thoracolumbar spine.Results: The mean age, average disease duration, and average DAS28 of the analyzed patients were 67.9 years, 14.9 years, and 2.8, respectively. Vertebral fractures were found in 33 patients (30.8%). In this population, 84.8% of patients with vertebral fractures and 59.5% of those without vertebral fractures were treated for osteoporosis with active vitamin D3, bisphosphonate, and/or denosumab. RA patients with vertebral fractures had significantly higher DAS28 values, a higher rate of patients with a history of glucocorticoid use, and lower BMD in comparison to those than without vertebral fractures (p = 0.009, p = 0.004, and p = 0.01, respectively). Logistic regression analysis showed DAS28 (p = 0.038) and BMD (p = 0.004) were independent factors associated with the presence of vertebral fractures. The ordered logistic regression analysis also showed DAS28 (p = 0.043) and BMD (p = 0.024) were independent factors that explained the number of vertebral fractures.Conclusions: Vertebral fractures were frequently observed in RA patients, even when patients were treated the recommended anti-osteoporotic agents. A high disease activity score and low BMD were associated with the presence and number of vertebral fractures in patients with RA.

scholarly journals Predictive risk factors for worse outcomes in COVID-19 patients with different clinical features at baseline

2021 ◽  
Author(s):  
Elisabetta Schiaroli ◽  
Anna Gidari ◽  
Giovanni Brachelente ◽  
Sabrina Bastianelli ◽  
Alfredo Villa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Critical Illness ◽  
Serum Ferritin ◽  
Logistic Regression Analysis ◽  
Severe Disease ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Neutrophil Lymphocyte Ratio

IntroductionCOVID-19 is characterized by a wide range of clinical expression and by possible progression to critical illness and death. Therefore it is essential to identify risk factors predicting progression towards serious and fatal diseases. The aim of our study was to identify laboratory predictive markers of clinical progression in patients with moderate/severe disease and in those with acute respiratory distress syndrome (ARDS).Material and methodsUsing electronic medical records for all demographic, clinical and laboratory data, a retrospective study on all consecutive patients with COVID-19 admitted to the Infectious Disease Clinic of Perugia was performed. The PaO2/FiO2 ratio (P/F) assessment cut‑off of 200 mm Hg was used at baseline to categorize the patients into two clinical groups. The progression towards invasive ventilation and/or death was used to identify critical outcome. Statistical analysis was performed. Multivariate logistic regression analysis was adopted to identify risk factors of critical illness and mortality.ResultsIn multivariate logistic regression analysis neutrophil/lymphocyte ratio (NLR) was the only significant predictive factor of progression to a critical outcome (p = 0.03) and of in-hospital mortality (p = 0.03). In ARDS patients no factors were associated with critical progression. Serum ferritin > 1006 ng/ml was the only predictive value of critical outcome in COVID-19 subjects with moderate/severe disease (p = 0.02).ConclusionsNeutrophil/lymphocyte ratio and serum ferritin are the only biomarkers that can help to stratify the risk of severity and mortality in patients with COVID-19.

scholarly journals Performance of cytokine models in predicting SLE activity

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Nopparat Ruchakorn ◽  
Pintip Ngamjanyaporn ◽  
Thanitta Suangtamai ◽  
Thanuchporn Kafaksom ◽  
Charin Polpanumas ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Disease Activity ◽  
Sensitivity And Specificity ◽  
Logistic Regression Analysis ◽  
Lupus Erythematosus ◽  
Activity Index ◽  
Multiple Logistic Regression Analysis ◽  
Negative Relationship ◽  
Complement C3

Abstract Background Identification of universal biomarkers to predict systemic lupus erythematosus (SLE) flares is challenging due to the heterogeneity of the disease. Several biomarkers have been reported. However, the data of validated biomarkers to use as a predictor for lupus flares show variation. This study aimed to identify the biomarkers that are sensitive and specific to predict lupus flares. Methods One hundred and twenty-four SLE patients enrolled in this study and were prospectively followed up. The evaluation of disease activity achieved by the SLE disease activity index (SLEDAI-2K) and clinical SLEDAI (modified SLEDAI). Patients with active SLE were categorized into renal or non-renal flares. Serum cytokines were measured by multiplex bead-based flow cytometry. The correlation and logistic regression analysis were performed. Results Levels of IFN-α, MCP-1, IL-6, IL-8, and IL-18 significantly increased in active SLE and correlated with clinical SLEDAI. Complement C3 showed a weakly negative relationship with IFN-α and IL-18. IL-18 showed the highest positive likelihood ratios for active SLE. Multiple logistic regression analysis showed that IL-6, IL-8, and IL-18 significantly increased odds ratio (OR) for active SLE at baseline while complement C3 and IL-18 increased OR for active SLE at 12 weeks. IL-18 and IL-6 yielded higher sensitivity and specificity than anti-dsDNA and C3 to predict active renal and active non-renal, respectively. Conclusion The heterogeneity of SLE pathogenesis leads to different signaling mechanisms and mediates through several cytokines. The monitoring of cytokines increases the sensitivity and specificity to determine SLE disease activity. IL-18 predicts the risk of active renal SLE while IL-6 and IL-8 predict the risk of active non-renal. The sensitivity and specificity of these cytokines are higher than the anti-dsDNA or C3. We propose to use the serum level of IL-18, IL-6, and IL-8 to monitor SLE disease activity in clinical practice.

14-3-3η Protein in Rheumatoid Arthritis: Promising Diagnostic Marker and Independent Risk Factor for Osteoporosis

2020 ◽  
Vol 51 (5) ◽  
pp. 529-539
Author(s):  
Tingting Zeng ◽  
Liming Tan ◽  
Yang Wu ◽  
Jianlin Yu
Keyword(s):  
Rheumatoid Arthritis ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Risk Factor ◽  
Logistic Regression Analysis ◽  
Independent Risk Factor ◽  
Multiple Logistic Regression Analysis ◽  
Area Under The Curve ◽  
Enzyme Linked Immunosorbent Assay ◽  
Disease Monitoring

Abstract Background Early identification and disease monitoring are challenges facing rheumatologists in the management of rheumatoid arthritis (RA). Methods We utilized enzyme-linked immunosorbent assay (ELISA) to determine 14-3-3η and anticyclic citrullinated peptide antibody (anti-CCP) levels, with rheumatoid factor (RF) level detected by rate nephelometry. The diagnostic value of each index was determined via receiver operating characteristic (ROC) curve, and the association between 14-3-3η and osteoporosis was assessed using multiple logistic regression analysis. Results Serum levels of 14-3-3η were 3.26 ng per mL in patients with RA. These levels were helpful in identifying patients with the disease, with the area under the curve (AUC) being 0.879 and 0.853, respectively, from all healthy control individuals and patients with RA. Combining 14-3-3η with RF or anti-CCP increased the diagnostic rate. Logistic regression analysis identified 14-3-3η as an independent risk factor for RA-related osteoporosis (odds ratio [OR], 1.503; 95% confidence interval [CI], 1.116–2.025; P <.01). Conclusions Serum 14-3-3η detection by itself or combined with other serum indices was helpful in differentiating patients with RA. Also, it was a promising biomarker for disease monitoring in RA.

scholarly journals Unexpected relationship between fat mass and basal metabolic rate in pregnant women

1996 ◽  
Vol 75 (5) ◽  
pp. 659-668 ◽  
Author(s):  
Michele N. Bronstein ◽  
Rosa P. Mak ◽  
Janet C. King*
Keyword(s):  
Regression Analysis ◽  
Pregnant Women ◽  
Multiple Regression Analysis ◽  
Multiple Regression ◽  
Fat Mass ◽  
Fat Free Mass ◽  
Data Set ◽  
Interaction Terms ◽  
Excessive Weight ◽  
Combined Data

We investigated the relationships between BMR, fat-free mass (FFM) and fat mass in pregnancy. BMR was measured by indirect calorimetry and body composition was assessed by densitometry in seventeen non-pregnant women (79·9 (SD 26·3, range 505−151·4) kg) and sixteen pregnant women (75·7 (SD 20·6, range 545−115·9) kg). The pregnant women were evaluated during weeks 31−35 of gestation. Multiple regression analysis of BMR with FFM and fat mass in the non-pregnant women showed that FFM was a highly significant predictor of BMR (P < 0·0001), but fat mass was not (P = 0·09). In contrast, in the pregnant women, multiple regression analysis revealed that fat mass was a highly significant predictor (P < 0·001), while FFM was not (P = 0·69). Evaluation of the interaction terms in the combined data set confirmed that the relationships of BMR with FFM and fat mass differ significantly in non-pregnant and pregnant women. It is proposed that pregnancy represents a unique condition during which BMR is regulated by maternal adipose reserves. An augmented BMR in overweight pregnant women may be protective, given that excessive weight gain may be detrimental to neonatal and maternal health.

scholarly journals Clinical Value of Patlak Ki Images Extracted From Dynamic 18F-FDG PET/CT For Evaluation of The Relationships Between Disease Activity and Clinical Events in Cardiac Sarcoidosis

2020 ◽  
Author(s):  
Masatoyo Nakajo ◽  
Satoko Ojima ◽  
Hirofumi Kawakami ◽  
Atsushi Tani ◽  
Akira Hirayama ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Disease Activity ◽  
Logistic Regression Analysis ◽  
Cardiac Dysfunction ◽  
Fdg Pet ◽  
Cardiac Sarcoidosis ◽  
Clinical Events ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background: Cardiac sarcoidosis (CS) has a poor prognosis because of frequent complication of atrioventricular block, ventricular tachycardia and congestive heart failure. Qualitative or quantitative 18F-FDG PET/CT has been used for diagnosing or assessing the disease activity of CS. However, the association between 18F-FDG myocardial uptake and clinical presentations in CS has not yet been clarified, and it is unknown if Patlak Ki images (Ki images) extracted from dynamic 18F-FDG-PET/CT are useful for evaluating the disease activity or clinical events in CS patients. In this context, this study was performed to investigate the usefulness of SUV and Patlak Ki images extracted from dynamic 18F-FDG-PET/CT for evaluating the risk of severe clinical events (SCEs) in CS. Methods: The SUV and Ki myocardial images were generated from 30 dynamic 18F-FDG-PET/CT scans of 21 CS patients including those with cardiac dysfunction and arrhythmic events. SUV parameters and Ki parameters (Ki max, Ki mean, Ki volume) were measured for positive myocardial lesions. The Mann–Whitney U-test or Fisher’s exact test was used appropriately to assess differences between quantitative variables or compare categorical data. The association between each quantitative parameter and presence of SCEs was analyzed by logistic regression analysis.Results: The SUV and Ki mages both were rated as positive in 19 scans and negative in 11 scans with the same incidence of SCEs which were significantly higher in positive than negative scans [cardiac dysfunction: 78.9% (15/19) vs. 27.2% (3/11), p=0.009; arrhythmic events: 65.5% (10/19) vs. 0% (0/11), p=0.004]. In 19 positive scans, neither SUV nor Ki parameters were significantly different between scans of patients with cardiac dysfunction (n=15) and those without (n=4) (p>0.05, each), whereas the three Ki parameters were significantly higher in scans for patients with arrhythmic events (n=10) than in those without (n=9) (p<0.05, each). Logistic regression analysis showed that the Ki volume alone was significantly associated with the risk of arrhythmic events (Odds ratio: 1.11, p=0.047).Conclusion: Patlak Ki images may add value to SUV images for evaluating the risk of SCEs in CS patients.

scholarly journals POS0221 COMPARISON OF TOFACITINIB AND BARICITINIB BY INVERSE PROBABILITY OF TREATMENT WEIGHTING ANALYSES BASED ON PROPENSITY SCORE IN PATIENTS WITH RHEUMATOID ARTHRITIS IN REAL CLINICAL PRACTICE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 329.1-329
Author(s):  
Y. Miyazaki ◽  
S. Nakayamada ◽  
K. Nakano ◽  
S. Kubo ◽  
Y. Inoue ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Clinical Practice ◽  
Disease Activity ◽  
Logistic Regression Analysis ◽  
Treatment Resistance ◽  
Multivariable Logistic Regression Analysis ◽  
Jak Inhibitors ◽  
Multivariable Logistic Regression ◽  
Group 3

Background:Tofacitinib (TOFA) and baricitinib (BARI) have been widely used in many regions for treatment of rheumatoid arthritis (RA). The selection of JAK inhibitor for RA treatment based on patient type remains a major concern.Objectives:The differences of efficacy between each Janus kinase (JAK) inhibitors have not been clarified in the patients with RA in clinical practice. Here, we compared the efficacy between TOFA and BARI in clinical practice.Methods:A retrospective observational study. The efficacy of TOFA (n=156) in patients with RA was compared with BARI (n=138). Selection bias was reduced to a minimum using propensity score-based inverse probability of treatment weighting (IPTW). We analyzed the trajectories of changes in disease activity in patients receiving TOFA or BARI using growth mixture modeling (GMM). Multivariable logistic regression analysis was performed to identify factors contributing to belonging to treatment-resistance group defined by GMM. The observation period of the study was 24 weeks.Results:No significant difference was observed in patient characteristics between the TOFA and BARI groups in after adjustment by propensity score-based IPTW. The retention rates over 24 weeks did not differ between the TOFA and BARI groups. No difference was observed in the incidence of adverse events in the TOFA and BARI groups. Clinical disease activity index (CDAI) at week 24 after the introduction of JAK inhibitors was 8.0 ± 8.9 and 6.2 ± 7.2 in the TOFA and BARI group, respectively. The rates of CDAI-remission at week 24 in the TOFA and BARI groups were 43/153 (28.3%) and 57/141 (40.4%), respectively. Compared to the TOFA group, the BARI group showed a significantly lower CDAI (⊿CDAI=-1.9, 95% confidence interval: -3.7 to -0.3, p=0.02) and a significantly higher rate of CDAI-remission (odds ratio: 1.7, 95% CI: 1.1–2.7, p=0.04) at week 24. Similarly, at week 24, SDAI was significantly lower in the BARI group (TOFA vs. BARI = 10.1 ± 9.9 vs. 7.3 ± 7.5, ⊿SDAI=-2.2, 95% CI: -4.2 to -0.2, p=0.04), and the rates of SDAI-remission (OR: 1.6, 95% CI: 1.0–2.6, p=0.04).The patients were divided into two groups: patients with MDA to HDA at baseline (Group 1) and patients with HDA at baseline than Group 1 (Groups 2 and 3) based on the analysis of the trajectories of CDAI using GMM, In Groups 1 and 2, disease activity was improved immediately after the introduction of JAK inhibitors. In Group 3, disease activity was partially improved, and LDA was not achieved at week 24 after the introduction of JAK inhibitors. The patients in Group 3 were resistant to treatment (Group 3: treatment-resistance group).When multivariable logistic regression analysis was performed for all patients receiving JAK inhibitors, the factors contributing to belonging to treatment-resistance group were: high baseline HAQ-DI score (OR: 1.76, 95% CI: 1.09–2.84, p=0.02) and high number of biological disease-modifying anti-rheumatic drugs (bDMARDs) used before JAK inhibitors (OR: 1.51, 95% CI: 1.16–1.95, p=0.002) and TOFA use (OR: 2.13, 95% CI: 1.05–4.30, p=0.03).Next, multivariable logistic regression analysis was separately performed for each treatment group. The patients receiving more bDMARDs before the JAK inhibitor were more likely to belong to treatment-resistance group in the TOFA group (OR: 1.76, 95% CI: 1.24–4.06). Among patients with RA who received TOFA, those who had received ≥4 bDMARDs before the introduction of TOFA were more likely to be classified into the treatment-resistant group.In the BARI group, multivariable logistic regression analysis did not identify any factors associated with belonging to treatment-resistance group.Conclusion:TOFA may be partially effective in patients resistant to many bDMARDs. Consequently, efficacy may differ between TOFA and BARI. Because TOFA was less effective in RA patients resistant to ≥4 bDMARDs, the present study suggests that BARI may be more appropriate for RA patients resistant to many bDMARDs.Disclosure of Interests:Yusuke Miyazaki Speakers bureau: Eli Lilly, Shingo Nakayamada Speakers bureau: Bristol-Myers, UCB, Astellas, Abbvie, Eisai, Pfizer, Takeda, Kazuhisa Nakano Speakers bureau: Bristol-Myers, Sanofi, AbbVie, Eisai, Eli Lilly, Chugai, Pfizer, Takeda, and Mitsubishi-Tanabe, Satoshi Kubo Speakers bureau: Bristol-Myers, Yoshino Inoue: None declared, Yoshihisa Fujino: None declared, Yoshiya Tanaka Speakers bureau: Abbvie, Daiichi-Sankyo, Chugai, Takeda, Mitsubishi-Tanabe, Bristol-Myers, Astellas, Eisai, Janssen, Pfizer, Asahi-kasei, Eli Lilly, GlaxoSmithKline, UCB, Teijin, MSD, and Santen

scholarly journals A Cohort Study of Liver Involvement in Patients With Adult-Onset Still's Disease: Prevalence, Characteristics and Impact on Prognosis

2020 ◽  
Vol 7 ◽  
Author(s):  
Huihui Chi ◽  
Zhihong Wang ◽  
Jianfen Meng ◽  
Pingyang Han ◽  
Limin Zhai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Disease Activity ◽  
Logistic Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Liver Involvement ◽  
Adult Onset Still’S Disease ◽  
Multivariate Logistic Regression ◽  
Adult Onset Still's Disease

Objective: Adult-onset Still's disease (AOSD) is a systemic disorder commonly accompanied by liver involvement. This study aims to illustrate the detailed information of liver abnormalities in patients with AOSD and evaluate the impact on the prognosis.Methods: A total number of 128 hospitalized patients, who met the Yamaguchi criteria of AOSD in the Department of Rheumatology and Immunology, Ruijin Hospital from July 2016 to August 2019 were consecutively enrolled and followed up. The demographic characteristics, clinical features, laboratory tests, treatments and prognosis were recorded. Correlations of liver function tests (LFTs) with disease activity and laboratory parameters were analyzed by the Spearman test. Risk factors of the refractory AOSD were evaluated by multivariate logistic regression analysis.Results: Liver involvement was presented in 104 (81.3%) patients with AOSD. We observed that 34 (32.7%) patients were with mild elevation, 32 (30.8%) patients were with moderate elevation, and 38 (36.5%) patients were with severe elevation. The majority of elevated ALT, AST and ALP decreased to normal within the range of 2 months, except for GGT. Furthermore, the LFTs were found significantly correlated with disease activity. Besides, we found patients with higher levels of LFTs tended to require more intensive treatments and suffered from poorer prognosis. Multivariate logistic regression analysis showed ALP ≥ 141 IU/L and GGT ≥ 132 IU/L are independent risk factors of refractory AOSD.Conclusion: Liver involvement is common in patients with AOSD, the levels of LFTs are associated with disease activity and related to the treatment strategies and prognosis.

Sign in / Sign up

Export Citation Format

Share Document