2024-03-29T12:38:37Z
https://nagoya.repo.nii.ac.jp/oai
oai:nagoya.repo.nii.ac.jp:00028288
2023-01-16T04:20:51Z
499:500:501
Predictors of biologic discontinuation due to insufficient response in patients with rheumatoid arthritis who achieved clinical remission with biologic treatment: A multicenter observational cohort study
Asai, Shuji
92266
Fujibayashi, Takayoshi
92267
Oguchi, Takeshi
92268
Hanabayashi, Masahiro
92269
Hayashi, Masatoshi
92270
Matsubara, Hiroyuki
92271
Ito, Takayasu
92272
Yabe, Yuichiro
92273
Watanabe, Tsuyoshi
92274
Hirano, Yuji
92275
Kanayama, Yasuhide
92276
Kaneko, Atsushi
92277
Kato, Takefumi
92278
Takagi, Hideki
92279
Takahashi, Nobunori
92280
Funahashi, Koji
92281
Takemoto, Toki
92282
Asai, Nobuyuki
92283
Watanabe, Tatsuo
92284
Ishiguro, Naoki
92285
Kojima, Toshihisa
92286
Biologics
glucocorticoids
relapse
remission
rheumatoid arthritis
Objective: This study aimed to investigate predictors of biologic discontinuation due to insufficient response as a surrogate for relapse in patients with rheumatoid arthritis (RA) who achieved clinical remission with biologic treatment. Methods: This study was performed based on data from a multicenter registry, and included 404 patients who achieved clinical remission within the first year of treatment with their first biologic. Cumulative retention rate of the first biologic was estimated using Kaplan–Meier curves, and the impact of patient characteristics on biologic discontinuation was assessed with Cox proportional hazards models. Results: During follow-up, 50 patients discontinued their first biologic due to insufficient response. Overall discontinuation rates due to insufficient response after achieving remission were 6%, 11%, and 19% at 1, 2, and 5 years, respectively. Multivariate analysis revealed that concomitant glucocorticoids at achieving remission [hazard ratio (HR): 3.80, 95% confidence interval (CI): 1.89–7.64)] and a higher level of C-reactive protein (CRP) at achieving remission (HR: 1.47 per 1 mg/dL, 95% CI: 1.09–1.99) independently predict discontinuation due to insufficient response after achieving remission. Conclusion: Patients with RA who achieved remission with concomitant glucocorticoid treatment and a higher level of CRP are at high risk of subsequent biologic discontinuation due to insufficient response.
Published online: 13 Jul 2017
journal article
Taylor & Francis
2018
application/pdf
Modern Rheumatology
2
28
221
226
1439-7595
1439-7609
https://nagoya.repo.nii.ac.jp/record/28288/files/relapse_MR_Manuscript_R2_clean_final.pdf
eng
https://doi.org/10.1080/14397595.2017.1332558
This is an Accepted Manuscript of an article published by Taylor & Francis Group in Modern Rheumatology on 13/07/2017, available online: http://www.tandfonline.com/10.1080/14397595.2017.1332558.