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.

Basic information

Original name

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

Authors

TUZIL, Jan (203 Czech Republic, guarantor), Tomas MLCOCH (203 Czech Republic), Jakub ZAVADA (203 Czech Republic), Michal SVOBODA (203 Czech Republic, belonging to the institution), Karel PAVELKA (203 Czech Republic) and Tomáš DOLEŽAL (203 Czech Republic, belonging to the institution)

Edition

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

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30226 Rheumatology

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 5.500

RIV identification code

RIV/00216224:14110/22:00128703

Organization unit

Faculty of Medicine

DOI

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

UT WoS

000789313000001

Keywords in English

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

Abstract

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 and 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, vol. 61, No 6, p. 2295-2306. ISSN 1462-0324. Available from: 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 and 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, vol.~61, No~6, p.~2295-2306. ISSN~1462-0324. Available from: https://dx.doi.org/10.1093/rheumatology/keab737.

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