RT Journal Article
SR Electronic
T1 Good clinical response, remission, and predictors of remission in rheumatoid arthritis patients treated with tumor necrosis factor-alpha blockers: the GISEA study.
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 1670
OP 1673
VO 34
IS 8
A1 Luana Mancarella
A1 Francesca Bobbio-Pallavicini
A1 Fulvia Ceccarelli
A1 Paola Chiara Falappone
A1 Angelo Ferrante
A1 Domenico Malesci
A1 Alfonso Massara
A1 Francesca Nacci
A1 Maria Elena Secchi
A1 Stefania Manganelli
A1 Fausto Salaffi
A1 Maria Lisa Bambara
A1 Stefano Bombardieri
A1 Maurizio Cutolo
A1 Clodoveo Ferri
A1 Mauro Galeazzi
A1 Roberto Gerli
A1 Roberto Giacomelli
A1 Walter Grassi
A1 Giovanni Lapadula
A1 Marco Matucci Cerinic
A1 Carlomaurizio Montecucco
A1 Francesco Trotta
A1 Giovanni Triolo
A1 Gabriele Valentini
A1 Guido Valesini
A1 Gianfranco F Ferraccioli
A1 GISEA group
YR 2007
UL http://www.jrheum.org/content/34/8/1670.abstract
AB OBJECTIVE: To assess the prevalence of good clinical response and remission in rheumatoid arthritis (RA) patients with longstanding disease treated with anti-tumor necrosis factor-alpha (TNF-alpha) drugs at outpatient clinics. METHODS: Retrospective national study of 14 academic tertiary referral rheumatology medical centers. RA patients with a Disease Activity Score (DAS28) > 3.2 were defined as having active disease and could start TNF-alpha blockers. All patients received one TNF-alpha blocker plus methotrexate (10-20 mg/wk). At the third month the patients were categorized as responders or nonresponders, based on improvement of at least 0.25 of the Health Assessment Questionnaire (HAQ). Those who had improved by at least 0.25 HAQ were analyzed for possible predictors of DAS28 remission at the sixth month. RESULTS: A total of 1257 patients started TNF-alpha blockers. Of these, 591 (46.7%) reached the sixth month with an improvement of HAQ of 0.25 at the third month. In the cohort of patients reaching HAQ of 0.25, DAS28 remission was seen in 24% of rheumatoid factor (RF)-positive and 36% of RF-negative patients (p = 0.03). Logistic regression analysis for predictors of remission identified age at baseline, HAQ < 1.63, and RF negativity as positive predictors of remission at 6 months along with sex (male). CONCLUSION: We show that only a minority of patients with longstanding RA achieve a good clinical response or remission at the outpatient community level. Predictors of remission identify characteristics commonly observed in subsets with less severe RA.