Objectives
To identify the clinical factors predicting a good clinical response to anti-TNF therapy in rheumatoid arthritis (RA) patients entered in the LORHEN registry after 5 years of treatment with anti-TNF agents and divided into two groups on the basis of their baseline DAS28聽scores (moderate > 3.2-5.1 [MDA] and high > 5.1 [HDA]).
Methods
Disease activity at baseline and after 12 months was assessed using the DAS28, and response was evaluated using the EULAR improvement criteria.
Results
The study involved 1300聽patients with established RA: 975 with HDA and 325聽with MDA. After a mean 36-month, 29.6% of the patients had a DAS28 score of less or equal to 2.6 (HDA 25.8% vs. MDA 43.0%; P < 0.001) and were considered to be in remission. A higher probability of a good EULAR response in patients with HDA was associated with male gender (F vs. M聽-聽OR 0.45, 95% CI 0.26-0.78; P: 0.004), lower age at the start of treatment (OR 0.98, 95% CI 0.96-0.99; P: 0.002), the absence of comorbidities (OR 0.18, 95% CI 0.06-0.52; P: 0.002) or no previous use of corticosteroids (OR 1.92, 95% CI 1.14-3.22; P: 0.015) and the use of adalimumab vs. infliximab (OR 2.21, 95% CI 1.37-3.57; P 0.001); in patients with MDA, the probability of a good EULAR response was associated with male gender (F vs. M聽-聽OR 0.39, 95% CI 0.17-0.90; P: 0.027).
Conclusions
With the exception of male gender, the factors predicting a good EULAR response are different in patients with MDA and those with HDA.
