Predictors of long‐term clinical remission in rheumatoid arthritis

Fornaro, Marco; Cacciapaglia, Fabio; Lopalco, Giuseppe; Venerito, Vincenzo; Iannone, Florenzo

doi:10.1111/eci.13363

Cited by 7 publications

(7 citation statements)

References 20 publications

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“…Multivariable analysis found low inclusion disease activity (DAS 28 score), and treatment by csDMARDs and bDMARDs as predictive factors of achieving sustained remission, this finding was concordant with previous studies 4 , 5 , 27 . Sex and presence of rheumatoid factors were associated with prognosis only in univariate analysis.…”

Section: Discussionsupporting

confidence: 90%

Increased remission with fewer corticosteroids and more biologics in rheumatoid arthritis at 7-year follow-up in real-life conditions

Larid

Vix

Garlantézec

et al. 2022

Sci Rep

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Remission in rheumatoid arthritis (RA) is an important therapeutic target that is not easy to achieve in real-life conditions. Some prognostic factors have been identified but the literature is variable. The objectives of this study were to evaluate the remission rate and the maintenance of remission in patients with RA over 7 years of follow-up in real-life conditions and to identify prognostic factors of long-term remission. Patients with RA seen at the Poitiers University Hospital were identified and clinical and biological data were collected. Data were analysed after 1 year and 7 years. Twice as many patients were in remission at 7 years than at 1 year of follow-up. 48.6% of patients who were not in remission at 1 year obtained remission at 7 years of follow-up. Patients achieving remission were more often receiving coprescription of csDMARDs and bDMARDs. Patients not in remission at 7 years were given more corticosteroids at higher doses. After 7 years of follow-up, low initial disease activity and use of csDMARDs and bDMARDs appeared to be independent positive predictive factors. Once obtained at one year, remission was maintained for 76% of our patients. As a conclusion, modern management of RA, whatever disease duration, leads to remission rates similar to those of early RA after 7 years of follow-up.

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Section: Discussionsupporting

confidence: 90%

Increased remission with fewer corticosteroids and more biologics in rheumatoid arthritis at 7-year follow-up in real-life conditions

Larid

Vix

Garlantézec

et al. 2022

Sci Rep

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“…24 Furthermore, most of the time predictors were not validated by bootstrapping or cross-validation, providing no information about either general validity or predictive performance. 7 Conversely, in recent years, the ML field developed prediction algorithms suitable for the heterogeneity of patients with rheumatic diseases.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, most of the time predictors were not validated by bootstrapping or cross-validation, providing no information about either general validity or predictive performance 7 …”

Section: Discussionmentioning

confidence: 99%

A Machine Learning Approach for Predicting Sustained Remission in Rheumatoid Arthritis Patients on Biologic Agents

et al. 2021

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Background: Despite several studies having identified factors associated with successful treatment outcomes in rheumatoid arthritis (RA), there is a lack of accurate predictive models for sustained remission in patients on biologic agents. To the best of our knowledge, no machine learning (ML) approaches apart from logistic regression (LR) have ever been tried on this class of problems.Methods: In this longitudinal study, patients with RA who started a biological disease-modifying antirheumatic drug (bDMARD) in a tertiary care center were analyzed. Demographic and clinical characteristics were collected at treatment baseline, 12-month, and 24-month follow-up. A wrapper feature selection algorithm was used to determine an attribute core set. Four different ML algorithms, namely, LR, random forest, K-nearest neighbors, and extreme gradient boosting, were then trained and validated with 10-fold cross-validation to predict 24-month sustained DAS28 (Disease Activity Score on 28 joints) remission. The performances of the algorithms were then compared assessing accuracy, precision, and recall.Results: Our analysis included 367 patients (female 323/367, 88%) with mean age ± SD of 53.7 ± 12.5 years at bDMARD baseline. Sustained DAS28 remission was achieved by 175 (47.2%) of 367 patients. The attribute core set used to train algorithms included acute phase reactant levels, Clinical Disease Activity Index, Health Assessment Questionnaire-Disability Index, as well as several clinical characteristics.

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“…[ 52 ] The European Alliance of Associations for Rheumatology (EULAR) recently updated the recommendations for managing RA. [ 53 ] Specifically, in patients with newly diagnosed RA, the guidelines recommend that the initial treatment should include methotrexate with other DMARDs or alone to achieve the absence of disease activity or low disease activity, and the treatment should be adjusted if no improvement is observed after 3 months. [ 54 ] The unmet medical needs in RA still exist for non‐responders who fail after 3 months, also defined as patients with high disease activity (HDA).…”

Section: Discussionmentioning

confidence: 99%

Inflammation‐Targeting Mesenchymal Stem Cells Combined with Photothermal Treatment Attenuate Severe Joint Inflammation

Shin,

Park,

Park

et al. 2023

Advanced Materials

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Current clinical therapeutic efficacy for the treatment of osteo‐ and rheumatoid‐arthritis is obviously limited. Although mesenchymal stem cells (MSCs) are considered as a source of promising regenerative therapy, un‐modified or genetically engineered MSCs injected in vivo restrict their clinical utility because of the low drug efficacy and unpredicted side effect, respectively. Herein, a strategy to enhance the migration efficacy of MSCs to inflamed joints via an inflammation‐mediated education process is demonstrated. To reinforce the limited anti‐inflammatory activity of MSCs, gold nanostar loaded with triamcinolone is conjugated to MSC. Furthermore, near‐infrared laser‐assisted photothermal therapy (PTT) induced by gold nanostar significantly elevates the anti‐inflammatory efficacy of the developed drugs, even in advanced stage arthritis model. An immunological regulation mechanism study of PTT is first suggested in this study; the expression of the interleukin 22 receptor, implicated in the pathogenesis of arthritis, is downregulated in T lymphocytes by PTT, and Th17 differentiation from naïve CD4 T cell is inhibited. Collectively, inflammation‐targeting MSCs conjugated with triamcinolone‐loaded gold nanostar (Edu‐MSCs‐AuS‐TA) promote the repolarization of macrophages and decrease neutrophil recruitment in joints. In addition, Edu‐MSCs‐AuS‐TA significantly alleviate arthritis‐associated pain, improve general locomotor activity, and more importantly, induce cartilage regeneration even for severe stages of arthritis model.

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Predictors of long‐term clinical remission in rheumatoid arthritis

Cited by 7 publications

References 20 publications

Increased remission with fewer corticosteroids and more biologics in rheumatoid arthritis at 7-year follow-up in real-life conditions

Increased remission with fewer corticosteroids and more biologics in rheumatoid arthritis at 7-year follow-up in real-life conditions

A Machine Learning Approach for Predicting Sustained Remission in Rheumatoid Arthritis Patients on Biologic Agents

Inflammation‐Targeting Mesenchymal Stem Cells Combined with Photothermal Treatment Attenuate Severe Joint Inflammation

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