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

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). Pooled analysis of nine national registries of patients with diagnosi...

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Bibliographic Details
Published in:EBioMedicine 2016-09, Vol.11 (C), p.302-306
Main Authors: Courvoisier, D.S., Alpizar-Rodriguez, D., Gottenberg, J.E., Hernandez, M.V., Iannone, F., Lie, E., Santos, M.J., Pavelka, K., Turesson, C., Mariette, X., Choquette, D., Hetland, M.L., Finckh, A.
Format: Article
Language:English
Subjects:
Abatacept
Antirheumatic Agents - therapeutic use
Arthritis, Rheumatoid - diagnosis
Arthritis, Rheumatoid - drug therapy
Biological Factors - therapeutic use
Biomarkers
Clinical Medicine
Comorbidity
DAS28
Disease activity
Disease Progression
Drug retention
Female
Follow-Up Studies
Humans
Klinisk medicin
Longitudinal data
Male
Medical and Health Sciences
Medicin och hälsovetenskap
Research Paper
Response rate
Reumatologi och inflammation
Rheumatoid arthritis
Rheumatology and Autoimmunity
Severity of Illness Index
Treatment Outcome
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Description
Summary: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). 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. 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 1year was much higher among ‘rapid responders’ (p
ISSN:2352-3964
2352-3964
DOI:10.1016/j.ebiom.2016.08.024