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

Courvoisier, D. S.; Alpizar-Rodriguez, D.; Gottenberg, J. E.; Hernandez, M. V.; Iannone, F.; Lie, E.; Santos, M. J.; Pavelka, K.; Turesson, C. LU and Mariette, X., et al. (2016) In EBioMedicine 11. p.302-306
Abstract

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... (More)

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.

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published
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keywords
Abatacept, DAS28, Disease activity, Drug retention, Longitudinal data, Response rate, Rheumatoid arthritis
in
EBioMedicine
volume
11
pages
5 pages
publisher
Elsevier
external identifiers
  • scopus:84994891207
  • wos:000386878100043
ISSN
2352-3964
DOI
10.1016/j.ebiom.2016.08.024
language
English
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yes
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e93a8b93-5b33-4c03-aa94-10b807267002
date added to LUP
2016-12-01 15:56:56
date last changed
2017-08-10 13:54:09
@article{e93a8b93-5b33-4c03-aa94-10b807267002,
  abstract     = {<p>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 &lt; 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.</p>},
  author       = {Courvoisier, D. S. and Alpizar-Rodriguez, D. and Gottenberg, J. E. and Hernandez, M. V. and Iannone, F. and Lie, E. and Santos, M. J. and Pavelka, K. and Turesson, C. and Mariette, X. and Choquette, D. and Hetland, M. L. and Finckh, A.},
  issn         = {2352-3964},
  keyword      = {Abatacept,DAS28,Disease activity,Drug retention,Longitudinal data,Response rate,Rheumatoid arthritis},
  language     = {eng},
  month        = {09},
  pages        = {302--306},
  publisher    = {Elsevier},
  series       = {EBioMedicine},
  title        = {Rheumatoid Arthritis Patients after Initiation of a New Biologic Agent : Trajectories of Disease Activity in a Large Multinational Cohort Study},
  url          = {http://dx.doi.org/10.1016/j.ebiom.2016.08.024},
  volume       = {11},
  year         = {2016},
}