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Observational study of optimization of biologic therapies in rheumatoid arthritis: a single-centre experience

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Abstract

To analyse the effectiveness of optimization of biologics in rheumatoid arthritis (RA). It was a single-centre retrospective observational study from January 2009 to September 2012. The effectiveness of the optimization of TNF antagonists, tocilizumab and abatacept in RA was studied. Optimization included predefined dose down-titration and/or expansion of dose interval in early arthritis with sustained DAS28-ESR <2.6 and established arthritis with a sustained DAS28-ESR <3.2. Primary outcome was time to relapse defined as increase in DAS28-ESR greater than 20 % over baseline. Cox’s regression analysis was performed to identify predictors of relapse. Sixty-four patients were included in the study. In the survival analysis, rates of relapse were 9.8 % at 6 months, 31.4 % at 12 months and 44.6 % at 18 months. Rates of patients with an increase in DAS28-ESR > 20 % and ≥1 inflamed joint at 6, 9 and 18 months were 1.6, 17.2 and 27.1 %, respectively. In relapsing patients, mean DAS28-ESR at relapse was 3.44 (2.94–4.79) and mean DAS28-ESR following the return to the prior dose of the biologic was 2.52 (1.42–3.21). No predictors of relapse were found in multivariate analysis. Optimization of the treatment with biologics in RA is an efficacious and safe treatment option.

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Acknowledgments

This work was partially supported by RETICS Program, RD08/0075 (RIER) from Instituto de Salud Carlos III (ISCIII), Spain.

Conflict of interest

J.J. G.-R. is on the Advisory Boards of BMS, Pfizer, Roche, Schering-Plough and UCB SA; has received lecture fees from BMS, Roche, Schering-Plough and Wyeth; and has received research grants from Roche and Schering-Plough. L.C. has received lecture fees from Abbott and Pfizer. All other authors have declared no conflicts of interest.

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Authors and Affiliations

  1. Rheumatology Department, Complejo Hospitalario Universitario de Santiago de Compostela, c/o Travesía da Choupana s/n, 15701, Santiago de Compostela, Spain

    Jose Ramon Maneiro, Eva Perez-Pampin, Eva Salgado, Loreto Carmona & Juan J. Gomez-Reino

  2. Health Sciences School, Universidad Camilo José Cela, Madrid, Spain

    Loreto Carmona

  3. Department of Medicine, Medical School, Universidad de Santiago, Santiago de Compostela, Spain

    Juan J. Gomez-Reino

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  1. Jose Ramon Maneiro
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  2. Eva Perez-Pampin
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  3. Eva Salgado
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  4. Loreto Carmona
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  5. Juan J. Gomez-Reino
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Correspondence to Jose Ramon Maneiro.

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Maneiro, J.R., Perez-Pampin, E., Salgado, E. et al. Observational study of optimization of biologic therapies in rheumatoid arthritis: a single-centre experience. Rheumatol Int 34, 1059–1063 (2014). https://doi.org/10.1007/s00296-013-2839-4

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  • DOI: https://doi.org/10.1007/s00296-013-2839-4

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