Rheumatoid Arthritis Patients after Initiation of a New Biologic Agent : Trajectories of Disease Activity in a Large Multinational Cohort Study

Background Response to disease modifying antirheumatic drugs (DMARDs) in rheumatoid arthritis (RA) is often heterogeneous. We aimed to identify types of disease activity trajectories following the initiation of a new biologic DMARD (bDMARD). Methods Pooled analysis of nine national registries of patients with diagnosis of RA, who initiated Abatacept and had at least two measures of disease activity (DAS28). We used growth mixture models to identify groups of patients with similar courses of treatment response, and examined these patients’ characteristics and effectiveness outcomes. Findings We identified three types of treatment response trajectories: ‘gradual responders’ (GR; 3576 patients, 91·7%) had a baseline mean DAS28 of 4·1 and progressive improvement over time; ‘rapid responders’ (RR; 219 patients, 5·6%) had higher baseline DAS28 and rapid improvement in disease activity; ‘inadequate responders’ (IR; 103 patients, 2·6%) had high DAS28 at baseline (5·1) and progressive worsening in disease activity. They were similar in baseline characteristics. Drug discontinuation for ineffectiveness was shorter among inadequate responders (p = 0.03), and EULAR good or moderate responses at 1 year was much higher among ‘rapid responders’ (p < 0.001). Interpretation Clinical information and baseline clinical characteristics do not allow a reliable prediction of which trajectory the patients will follow after bDMARD initiation.

Alpizar-Rodriguez, D.Geneva University Hospital (författare)
Gottenberg, J. E.University Hospital Of Strasbourg (författare)
Hernandez, M. V.Hospital Clínic of Barcelona (författare)
Iannone, F.Bari University Hospital (författare)
Lie, E.Diakonhjemmet Hospital (författare)
Santos, M. J.University of Lisbon (författare)
Pavelka, K. (författare)
Turesson, C.Lund University,Lunds universitet,Reumatologi och molekylär skelettbiologi,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Rheumatology,Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)med-ctn (författare)
Mariette, X.University of Paris-Saclay (författare)
Choquette, D.Institut de Rhumatologie de Montréal (författare)
Hetland, M. L.University of Copenhagen (författare)
Finckh, A.Geneva University Hospital (författare)
Geneva University HospitalUniversity Hospital Of Strasbourg (creator_code:org_t)

Av författaren/redakt...: Courvoisier, D. ...; Alpizar-Rodrigue ...; Gottenberg, J. E ...; Hernandez, M. V.; Iannone, F.; Lie, E.; visa fler...; Santos, M. J.; Pavelka, K.; Turesson, C.; Mariette, X.; Choquette, D.; Hetland, M. L.; Finckh, A.; visa färre...

Om ämnet

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Reumatologi och ...

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.