Comparison of remission criteria in a tumour necrosis factor inhibitor treated rheumatoid arthritis longitudinal cohort: patient global health is a confounder

Hdl Handle:
http://hdl.handle.net/10147/312383
Title:
Comparison of remission criteria in a tumour necrosis factor inhibitor treated rheumatoid arthritis longitudinal cohort: patient global health is a confounder
Authors:
Balogh, Emese; Dias, Joao M; Orr, Carl; Mullan, Ronan; Harty, Len; FitzGerald, Oliver; Gallagher, Phil; Molloy, Miriam; O’Flynn, Eileen; Kelly, Alexia; Minnock, Patricia; O’Neill, Madeline; Moore, Louise; Murray, Mairead; Fearon, Ursula; Veale, Douglas J
Citation:
Arthritis Research & Therapy. 2013 Dec 24;15(6):R221
Issue Date:
24-Dec-2013
URI:
http://dx.doi.org/10.1186/ar4421; http://hdl.handle.net/10147/312383
Abstract:
Abstract Introduction Our objectives were to assess the frequency and sustainability of American College of Rheumatology (ACR)/European League against Rheumatism (EULAR) and Disease Activity Score (DAS)28(4v)–C-reactive protein (CRP) remission 12 months after the initiation of tumour necrosis factor inhibitor (TNFi) therapy in a rheumatoid arthritis (RA) cohort. Methods Data were collected of 273 biologic naive RA patients at baseline, then 3, 6 and 12 months post-TNFi therapy. Remission status was calculated using DAS28(4v)-CRP <2.6 and ACR/EULAR Boolean criteria. Response was scored using EULAR criteria. Results Mean (range) patient age was 59.9 (7.2-85.4) years with disease duration of 13.4 (1.0-52.0) years. Responder status maintained from 3–12 months (86%, 82.4%), laboratory/clinical parameters (erythrocyte sedimentation rate (ESR), CRP, patient global health (PGH), DAS28(4v)-CRP) also showed sustained improvement (P < 0.05). DAS28 remission was reached by 102 subjects at 1 year, 27 patients were in Boolean remission, but 75 missed it from the DAS28 remission group. Patients in remission were younger (P = 0.041) with lower baseline tender joint count (TJC)28 and PGH than those not in remission (P = 0.001, P = 0.047). DAS28 remission patients were older (P = 0.026) with higher 12 months PGH and subsequently higher DAS28 than Boolean remission patients (P < 0.0001). Patients not achieving Boolean remission due to missing one subcriteria most frequently missed PGH ≤1 criteria (79.8%). Conclusions Only 10% of this TNFi treated cohort achieved remission according to the new ACR/EULAR criteria, which requires lower disease activity. More stringent criteria may ensure further resolution of disease activity and better longterm radiographic outcome, which supports earlier intervention with biologic therapy in RA.
Language:
en
Keywords:
GLOBAL HEALTH; ARTHRITIS

Full metadata record

DC FieldValue Language
dc.contributor.authorBalogh, Emeseen_GB
dc.contributor.authorDias, Joao Men_GB
dc.contributor.authorOrr, Carlen_GB
dc.contributor.authorMullan, Ronanen_GB
dc.contributor.authorHarty, Lenen_GB
dc.contributor.authorFitzGerald, Oliveren_GB
dc.contributor.authorGallagher, Philen_GB
dc.contributor.authorMolloy, Miriamen_GB
dc.contributor.authorO’Flynn, Eileenen_GB
dc.contributor.authorKelly, Alexiaen_GB
dc.contributor.authorMinnock, Patriciaen_GB
dc.contributor.authorO’Neill, Madelineen_GB
dc.contributor.authorMoore, Louiseen_GB
dc.contributor.authorMurray, Maireaden_GB
dc.contributor.authorFearon, Ursulaen_GB
dc.contributor.authorVeale, Douglas Jen_GB
dc.date.accessioned2014-02-07T16:30:46Z-
dc.date.available2014-02-07T16:30:46Z-
dc.date.issued2013-12-24-
dc.identifier.citationArthritis Research & Therapy. 2013 Dec 24;15(6):R221en_GB
dc.identifier.urihttp://dx.doi.org/10.1186/ar4421-
dc.identifier.urihttp://hdl.handle.net/10147/312383-
dc.description.abstractAbstract Introduction Our objectives were to assess the frequency and sustainability of American College of Rheumatology (ACR)/European League against Rheumatism (EULAR) and Disease Activity Score (DAS)28(4v)–C-reactive protein (CRP) remission 12 months after the initiation of tumour necrosis factor inhibitor (TNFi) therapy in a rheumatoid arthritis (RA) cohort. Methods Data were collected of 273 biologic naive RA patients at baseline, then 3, 6 and 12 months post-TNFi therapy. Remission status was calculated using DAS28(4v)-CRP <2.6 and ACR/EULAR Boolean criteria. Response was scored using EULAR criteria. Results Mean (range) patient age was 59.9 (7.2-85.4) years with disease duration of 13.4 (1.0-52.0) years. Responder status maintained from 3–12 months (86%, 82.4%), laboratory/clinical parameters (erythrocyte sedimentation rate (ESR), CRP, patient global health (PGH), DAS28(4v)-CRP) also showed sustained improvement (P < 0.05). DAS28 remission was reached by 102 subjects at 1 year, 27 patients were in Boolean remission, but 75 missed it from the DAS28 remission group. Patients in remission were younger (P = 0.041) with lower baseline tender joint count (TJC)28 and PGH than those not in remission (P = 0.001, P = 0.047). DAS28 remission patients were older (P = 0.026) with higher 12 months PGH and subsequently higher DAS28 than Boolean remission patients (P < 0.0001). Patients not achieving Boolean remission due to missing one subcriteria most frequently missed PGH ≤1 criteria (79.8%). Conclusions Only 10% of this TNFi treated cohort achieved remission according to the new ACR/EULAR criteria, which requires lower disease activity. More stringent criteria may ensure further resolution of disease activity and better longterm radiographic outcome, which supports earlier intervention with biologic therapy in RA.-
dc.language.isoenen
dc.subjectGLOBAL HEALTHen_GB
dc.subjectARTHRITISen_GB
dc.titleComparison of remission criteria in a tumour necrosis factor inhibitor treated rheumatoid arthritis longitudinal cohort: patient global health is a confounderen_GB
dc.language.rfc3066en-
dc.rights.holderEmese Balogh et al.; licensee BioMed Central Ltd.-
dc.description.statusPeer Reviewed-
dc.date.updated2014-01-30T16:23:06Z-
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