Time in remission as an alternative outcome measure for
rheumatoid arthritis: a 10-year prospective study of 2618 new
users of anti-TNF

J 2022

Time in remission as an alternative outcome measure for rheumatoid arthritis: a 10-year prospective study of 2618 new users of anti-TNF

TUZIL, Jan, Tomas MLCOCH, Jakub ZAVADA, Michal SVOBODA, Karel PAVELKA et. al.

Základní údaje

Originální název

Time in remission as an alternative outcome measure for rheumatoid arthritis: a 10-year prospective study of 2618 new users of anti-TNF

Autoři

TUZIL, Jan (203 Česká republika, garant), Tomas MLCOCH (203 Česká republika), Jakub ZAVADA (203 Česká republika), Michal SVOBODA (203 Česká republika, domácí), Karel PAVELKA (203 Česká republika) a Tomáš DOLEŽAL (203 Česká republika, domácí)

Vydání

RHEUMATOLOGY, OXFORD, OXFORD UNIV PRESS, 2022, 1462-0324

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30226 Rheumatology

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 5.500

Kód RIV

RIV/00216224:14110/22:00128703

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1093/rheumatology/keab737

UT WoS

000789313000001

Klíčová slova anglicky

RA; outcome measure; disease activity; remission; biological therapy; anti-TNF; interpolation; prediction; registry; Czech Republic

Štítky

14110516, 14119612, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 22. 2. 2023 14:17, Mgr. Tereza Miškechová

Anotace

V originále

Objective. Achieving targeted disease activity (DA) is the primary therapeutic strategy in RA. Point measurements of DA are done at out-patient visits, however true DA between visits remains unobserved. This study sought to describe and validate a new outcome measure, i.e. time in remission (TIR). Methods. Patients were enrolled in the Czech ATTRA-RA registry. TIR was calculated using linear interpolation of the DAS28-ESR determined at outpatient visits. Correlation coefficients were computed between TIR and DAS28-CRP, HAQ, Simple Disease Activity Index (SDAI), patient global assessment (PGA) and physician global assessment (PhGA). Using logistic regression, TIR was used as a predictor of remission (SDAI <= 3.3) and non-disability (HAQ <0.5). The predictive value of TIR was compared with point and sustained remission using the cross-validated area under receiver-operating curves. Results. Since 2010, 2618 RA patients started anti-TNF therapy and were followed until 2020 or until treatment discontinuation. During the first 6months of therapy, 56% of patients had no remission (TIR =0), and 22% of patients reached sustained remission (TIR =1), while 22% of patients had point remissions with 0< TIR < 1. EULAR good responders and moderate/non-responders spent 64 +/- 42% and 6 +/- 18% of time in remission, respectively. The mean TIR grew during the follow-up and was correlated with DAS28-CRP, SDAI, HAQ, PGA, and PhGA (P < 0.0001). TIR at 3 and 6months predicted remission (SDAI <= 3.3) and non-disability (HAQ <0.5) at 13 and 19 months better than point or sustained remission. Conclusions. TIR is an intuitive way of estimating unobserved DA between scheduled visits; its calculation only requires two consecutive DA values

Citovat

TUZIL, Jan, Tomas MLCOCH, Jakub ZAVADA, Michal SVOBODA, Karel PAVELKA a Tomáš DOLEŽAL. Time in remission as an alternative outcome measure for rheumatoid arthritis: a 10-year prospective study of 2618 new users of anti-TNF. RHEUMATOLOGY. OXFORD: OXFORD UNIV PRESS, 2022, roč. 61, č. 6, s. 2295-2306. ISSN 1462-0324. Dostupné z: https://dx.doi.org/10.1093/rheumatology/keab737.

@article{2259297,
   author = {Tuzil, Jan and Mlcoch, Tomas and Zavada, Jakub and Svoboda, Michal and Pavelka, Karel and Doležal, Tomáš},
   article_location = {OXFORD},
   article_number = {6},
   doi = {http://dx.doi.org/10.1093/rheumatology/keab737},
   keywords = {RA; outcome measure; disease activity; remission; biological therapy; anti-TNF; interpolation; prediction; registry; Czech Republic},
   language = {eng},
   issn = {1462-0324},
   journal = {RHEUMATOLOGY},
   title = {Time in remission as an alternative outcome measure for rheumatoid arthritis: a 10-year prospective study of 2618 new users of anti-TNF},
   url = {https://academic.oup.com/rheumatology/article/61/6/2295/6380444?login=true},
   volume = {61},
   year = {2022}
}

TY  - JOUR
ID  - 2259297
AU  - Tuzil, Jan - Mlcoch, Tomas - Zavada, Jakub - Svoboda, Michal - Pavelka, Karel - Doležal, Tomáš
PY  - 2022
TI  - Time in remission as an alternative outcome measure for rheumatoid arthritis: a 10-year prospective study of 2618 new users of anti-TNF
JF  - RHEUMATOLOGY
VL  - 61
IS  - 6
SP  - 2295-2306
EP  - 2295-2306
PB  - OXFORD UNIV PRESS
SN  - 14620324
KW  - RA
KW  - outcome measure
KW  - disease activity
KW  - remission
KW  - biological therapy
KW  - anti-TNF
KW  - interpolation
KW  - prediction
KW  - registry
KW  - Czech Republic
UR  - https://academic.oup.com/rheumatology/article/61/6/2295/6380444?login=true
N2  - Objective. Achieving targeted disease activity (DA) is the primary therapeutic strategy in RA. Point measurements of DA are done at out-patient visits, however true DA between visits remains unobserved. This study sought to describe and validate a new outcome measure, i.e. time in remission (TIR). Methods. Patients were enrolled in the Czech ATTRA-RA registry. TIR was calculated using linear interpolation of the DAS28-ESR determined at outpatient visits. Correlation coefficients were computed between TIR and DAS28-CRP, HAQ, Simple Disease Activity Index (SDAI), patient global assessment (PGA) and physician global assessment (PhGA). Using logistic regression, TIR was used as a predictor of remission (SDAI <= 3.3) and non-disability (HAQ <0.5). The predictive value of TIR was compared with point and sustained remission using the cross-validated area under receiver-operating curves. Results. Since 2010, 2618 RA patients started anti-TNF therapy and were followed until 2020 or until treatment discontinuation. During the first 6months of therapy, 56% of patients had no remission (TIR =0), and 22% of patients reached sustained remission (TIR =1), while 22% of patients had point remissions with 0< TIR < 1. EULAR good responders and moderate/non-responders spent 64 +/- 42% and 6 +/- 18% of time in remission, respectively. The mean TIR grew during the follow-up and was correlated with DAS28-CRP, SDAI, HAQ, PGA, and PhGA (P < 0.0001). TIR at 3 and 6months predicted remission (SDAI <= 3.3) and non-disability (HAQ <0.5) at 13 and 19 months better than point or sustained remission. Conclusions. TIR is an intuitive way of estimating unobserved DA between scheduled visits; its calculation only requires two consecutive DA values
ER  -

TUZIL, Jan, Tomas MLCOCH, Jakub ZAVADA, Michal SVOBODA, Karel PAVELKA a Tomáš DOLEŽAL. Time in remission as an alternative outcome measure for rheumatoid arthritis: a 10-year prospective study of 2618 new users of anti-TNF. \textit{RHEUMATOLOGY}. OXFORD: OXFORD UNIV PRESS, 2022, roč.~61, č.~6, s.~2295-2306. ISSN~1462-0324. Dostupné z: https://dx.doi.org/10.1093/rheumatology/keab737.

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