When to initiate and discontinue biologic treatments for rheumatoid arthritis?

Chatzidionysiou, Katerina; Vollenhoven, Ronald F. van

doi:10.1111/j.1365-2796.2011.02355.x

Cited by 22 publications

(12 citation statements)

References 47 publications

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“…4 Hence, strategies to manage patients with RA in remission, including the possibility to taper or even stop treatment, gain growing importance. [5][6][7][8] Especially, predictive markers are needed for identifying patients, in which treatment can be successfully tapered without facing a high risk for relapse of RA.…”

Section: Introductionmentioning

confidence: 99%

Prediction of disease relapses by multibiomarker disease activity and autoantibody status in patients with rheumatoid arthritis on tapering DMARD treatment

et al. 2015

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ObjectiveTo analyse the role of multibiomarker disease activity (MBDA) score in predicting disease relapses in patients with rheumatoid arthritis (RA) in sustained remission who tapered disease modifying antirheumatic drug (DMARD) therapy in RETRO, a prospective randomised controlled trial.MethodsMBDA scores (scale 1–100) were determined based on 12 inflammation markers in baseline serum samples from 94 patients of the RETRO study. MBDA scores were compared between patients relapsing or remaining in remission when tapering DMARDs. Demographic and disease-specific parameters were included in multivariate logistic regression analysis for defining predictors of relapse.ResultsModerate-to-high MBDA scores were found in 33% of patients with RA overall. Twice as many patients who relapsed (58%) had moderate/high MBDA compared with patients who remained in remission (21%). Baseline MBDA scores were significantly higher in patients with RA who were relapsing than those remaining in stable remission (N=94; p=0.0001) and those tapering/stopping (N=59; p=0.0001). Multivariate regression analysis identified MBDA scores as independent predictor for relapses in addition to anticitrullinated protein antibody (ACPA) status. Relapse rates were low (13%) in patients who were MBDA−/ACPA−, moderate in patients who were MBDA+/ACPA− (33.3%) and MBDA−ACPA+ (31.8%) and high in patients who were MBDA+/ACPA+ (76.4%).ConclusionsMBDA improved the prediction of relapses in patients with RA in stable remission undergoing DMARD tapering. If combined with ACPA testing, MBDA allowed prediction of relapse in more than 80% of the patients.Trial registration numberEudraCT 2009-015740-42.

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Section: Introductionmentioning

confidence: 99%

Prediction of disease relapses by multibiomarker disease activity and autoantibody status in patients with rheumatoid arthritis on tapering DMARD treatment

et al. 2015

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“…When to initiate biological agents in the course of the disease has been an issue of much discussion 4,5,6 , yet according to the new American College of Rheumatology guidelines 7 , biologic agents are recommended for early and established RA with moderate to high disease activity and/or poor prognosis features (e.g., positive rheumatoid factor or anticitrullinated protein antibodies), thus increasing the proportion of patients who are candidates for their use. When to initiate biological agents in the course of the disease has been an issue of much discussion 4,5,6 , yet according to the new American College of Rheumatology guidelines 7 , biologic agents are recommended for early and established RA with moderate to high disease activity and/or poor prognosis features (e.g., positive rheumatoid factor or anticitrullinated protein antibodies), thus increasing the proportion of patients who are candidates for their use.…”

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confidence: 99%

Sustained Clinical Remission and Rate of Relapse After Tocilizumab Withdrawal in Patients with Rheumatoid Arthritis

Aguilar-Lozano

Castillo-Ortiz²,

Vargas-Serafin³

et al. 2013

J Rheumatol

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“…However, many patients do not respond well, lose their clinical response, or experience adverse events with TNFi (11)(12)(13)(14). Although patients with an inadequate response to one TNFi may be switched to a second TNFi, patients may experience progressive loss of efficacy with a subsequent TNFi (15). In addition, response to treatment, physical function, and other PROs decrease with more failed therapies and longer disease duration (16).…”

Section: Introductionmentioning

confidence: 99%

Tofacitinib With Methotrexate in Third‐Line Treatment of Patients With Active Rheumatoid Arthritis: Patient‐Reported Outcomes From a Phase III Trial

Strand¹,

Burmester

Zerbini

et al. 2015

Arthritis Care & Research

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Objective. To assess patient-reported outcomes (PROs) for tofacitinib, an oral JAK inhibitor for the treatment of rheumatoid arthritis (RA), in a 6-month, phase III, randomized controlled trial. Methods. Patients ages >18 years with active RA with an inadequate response to >1 tumor necrosis factor inhibitor (TNFi) and receiving stable background methotrexate were randomized 2:2:1:1 to tofacitinib 5 mg or 10 mg twice daily, or placebo advanced to tofacitinib 5 mg or 10 mg twice daily at month 3. PROs measured at month 3 included patient global assessment of disease activity ( Results. Patients received tofacitinib 5 mg (n ‫؍‬ 133) or 10 mg (n ‫؍‬ 134) or placebo advanced to tofacitinib 5 mg (n ‫؍‬ 66) or 10 mg (n ‫؍‬ 66). HAQ DI (reported previously), PtGA (P < 0.0001), and SF-36v2 physical and mental component summary (P < 0.05) scores were improved for both tofacitinib doses versus placebo. Furthermore, improvements greater than or equal to the minimum clinically important difference were more frequently reported by tofacitinib-treated patients versus placebo for PtGA (P < 0.05), pain (P < 0.0001), HAQ DI (P < 0.05), SF-36v2 physical and mental component summary scores (P < 0.05), and FACIT-F (P < 0.001 for 5 mg twice daily). No statistical differences were observed in the MOS Sleep Scale. Conclusion. Tofacitinib treatment resulted in significant, clinically meaningful improvements in multiple PROs versus placebo over 3 months of treatment in patients with active RA and a previous inadequate response to TNFi.

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When to initiate and discontinue biologic treatments for rheumatoid arthritis?

Abstract: Abstract. Chatzidionysiou K, van Vollenhoven RF

Cited by 22 publications

References 47 publications

Prediction of disease relapses by multibiomarker disease activity and autoantibody status in patients with rheumatoid arthritis on tapering DMARD treatment

Prediction of disease relapses by multibiomarker disease activity and autoantibody status in patients with rheumatoid arthritis on tapering DMARD treatment

Sustained Clinical Remission and Rate of Relapse After Tocilizumab Withdrawal in Patients with Rheumatoid Arthritis

Tofacitinib With Methotrexate in Third‐Line Treatment of Patients With Active Rheumatoid Arthritis: Patient‐Reported Outcomes From a Phase III Trial

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