Effect of disease duration and prior disease-modifying antirheumatic drug use on treatment outcomes in patients with rheumatoid arthritis

Autor: Josef S Smolen, Dave Nicholls, Daniel Aletaha, Jen-Fue Maa, Stefan Florentinus, Sung-Hwan Park, Su Chen, Daniel Furtner
Rok vydání: 2019
Předmět:
Male
musculoskeletal diseases
medicine.medical_specialty
Time Factors
dmards (synthetic)
Disease duration
medicine.medical_treatment
Immunology
Treatment outcome
Rheumatoid Arthritis
Severity of Illness Index
General Biochemistry
Genetics and Molecular Biology
Arthritis
Rheumatoid
03 medical and health sciences
tnf-alpha
0302 clinical medicine
Double-Blind Method
Rheumatology
Internal medicine
medicine
Adalimumab
Humans
DAS28
Immunology and Allergy
In patient
030212 general & internal medicine
Disease-modifying antirheumatic drug
skin and connective tissue diseases
030203 arthritis & rheumatology
Dose-Response Relationship
Drug
business.industry
Middle Aged
medicine.disease
C-Reactive Protein
Methotrexate
Treatment Outcome
Antirheumatic Agents
Rheumatoid arthritis
Disease Progression
Drug Therapy
Combination
Female
business
Follow-Up Studies
medicine.drug
Zdroj: Annals of the Rheumatic Diseases
ISSN: 1468-2060
0003-4967
DOI: 10.1136/annrheumdis-2018-214918
Popis: ObjectivesTo determine if disease duration and number of prior disease-modifying antirheumatic drugs (DMARDs) affect response to therapy in patients with established rheumatoid arthritis (RA).MethodsAssociations between disease duration or number of prior DMARDs and response to therapy were assessed using data from two randomised controlled trials in patients with established RA (mean duration, 11 years) receiving adalimumab+methotrexate. Response to therapy was assessed at week 24 using disease activity outcomes, including 28-joint Disease Activity Score based on C-reactive protein (DAS28(CRP)), Simplified Disease Activity Index (SDAI) and Health Assessment Questionnaire Disability Index (HAQ-DI), and proportions of patients with 20%/50%/70% improvement in American College of Rheumatology (ACR) responses.ResultsIn the larger study (N=207), a greater number of prior DMARDs (>2 vs 0–1) was associated with smaller improvements in DAS28(CRP) (–1.8 vs –2.2), SDAI (–22.1 vs –26.9) and HAQ-DI (–0.43 vs –0.64) from baseline to week 24. RA duration of >10 years versus ConclusionsNumber of prior DMARDs and disease duration affect responses to therapy in patients with established RA. Furthermore, number of prior DMARDs, regardless of disease duration, has a limiting effect on the potential response to adalimumab therapy.
Databáze: OpenAIRE
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