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Is swollen to tender joint count ratio a new and useful clinical marker for biologic drug response in rheumatoid arthritis? Results from a Swedish cohort

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@article{664b7a7b69484e2b845895a4c89a84f9,
title = "Is swollen to tender joint count ratio a new and useful clinical marker for biologic drug response in rheumatoid arthritis?: Results from a Swedish cohort",
abstract = "OBJECTIVE: To study the impact of swollen to tender joint count ratio (STR) and other baseline characteristics on treatment response to a first course of anti-tumor necrosis factor (anti-TNF) therapy in rheumatoid arthritis (RA) patients.METHODS: Patients with RA initiating their first course of anti-TNF treatment were included in a structured clinical followup protocol. Based on pragmatic thresholds and plausibility, patients were categorized as having low (STR <0.5), moderate (0.5 ≤ STR ≤ 1.0), or high (STR >1.0) joint count ratios. The data were collected and followed during the period of March 1999 through December 2010.RESULTS: A total of 2,507 patients were included in the study (median age 56 years, 78{\%} women). Of these patients, 344 (14{\%}) had a low STR, 1,180 (47{\%}) had a moderate STR, and 983 (39{\%}) had a high STR. According to these STR thresholds, 23{\%} of patients (95{\%} confidence interval [95{\%} CI] 18-29{\%}) with low, 39{\%} (95{\%} CI 35-43{\%}) with moderate, and 40{\%} (95{\%} CI 36-44{\%}) with high STR achieved the American College of Rheumatology criteria for 50{\%} improvement (ACR50) response at 6 months after initiation. Correlation tests showed that STR was associated with ACR50 response independent of both swollen and tender joint counts. Logistic regression analysis consistently showed that moderate STR, high STR, not using prednisolone, high baseline Disease Activity Score in 28 joints, and low baseline Health Assessment Questionnaire scores were significantly associated with favorable ACR50 response with odds ratios of 1.93 (P < 0.01), 2.82 (P < 0.01), 0.65 (P < 0.01), 1.49 (P < 0.01), and 0.47 (P < 0.01), respectively.CONCLUSION: STR is a new and feasible predictor of treatment response in RA. RA patients with a moderate to high STR have a 2- to 3-fold increased likelihood of responding according to ACR50 criteria.",
keywords = "Antirheumatic Agents, Arthritis, Rheumatoid, Chi-Square Distribution, Disability Evaluation, Feasibility Studies, Female, Follow-Up Studies, Glucocorticoids, Humans, Joints, Logistic Models, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Predictive Value of Tests, Prednisolone, Proportional Hazards Models, Questionnaires, ROC Curve, Registries, Severity of Illness Index, Sweden, Time Factors, Treatment Outcome, Tumor Necrosis Factor-alpha",
author = "Kristensen, {Lars Erik} and Henning Bliddal and Robin Christensen and Karlsson, {Johan A} and Anders G{\"u}lfe and Tore Saxne and Pierre Geborek",
note = "Copyright {\circledC} 2014 by the American College of Rheumatology.",
year = "2014",
month = "2",
doi = "10.1002/acr.22107",
language = "English",
volume = "66",
pages = "173--9",
journal = "Arthritis Care & Research",
issn = "2151-464X",
publisher = "JohnWiley & Sons, Inc",
number = "2",

}

RIS

TY - JOUR

T1 - Is swollen to tender joint count ratio a new and useful clinical marker for biologic drug response in rheumatoid arthritis?

T2 - Results from a Swedish cohort

AU - Kristensen, Lars Erik

AU - Bliddal, Henning

AU - Christensen, Robin

AU - Karlsson, Johan A

AU - Gülfe, Anders

AU - Saxne, Tore

AU - Geborek, Pierre

N1 - Copyright © 2014 by the American College of Rheumatology.

PY - 2014/2

Y1 - 2014/2

N2 - OBJECTIVE: To study the impact of swollen to tender joint count ratio (STR) and other baseline characteristics on treatment response to a first course of anti-tumor necrosis factor (anti-TNF) therapy in rheumatoid arthritis (RA) patients.METHODS: Patients with RA initiating their first course of anti-TNF treatment were included in a structured clinical followup protocol. Based on pragmatic thresholds and plausibility, patients were categorized as having low (STR <0.5), moderate (0.5 ≤ STR ≤ 1.0), or high (STR >1.0) joint count ratios. The data were collected and followed during the period of March 1999 through December 2010.RESULTS: A total of 2,507 patients were included in the study (median age 56 years, 78% women). Of these patients, 344 (14%) had a low STR, 1,180 (47%) had a moderate STR, and 983 (39%) had a high STR. According to these STR thresholds, 23% of patients (95% confidence interval [95% CI] 18-29%) with low, 39% (95% CI 35-43%) with moderate, and 40% (95% CI 36-44%) with high STR achieved the American College of Rheumatology criteria for 50% improvement (ACR50) response at 6 months after initiation. Correlation tests showed that STR was associated with ACR50 response independent of both swollen and tender joint counts. Logistic regression analysis consistently showed that moderate STR, high STR, not using prednisolone, high baseline Disease Activity Score in 28 joints, and low baseline Health Assessment Questionnaire scores were significantly associated with favorable ACR50 response with odds ratios of 1.93 (P < 0.01), 2.82 (P < 0.01), 0.65 (P < 0.01), 1.49 (P < 0.01), and 0.47 (P < 0.01), respectively.CONCLUSION: STR is a new and feasible predictor of treatment response in RA. RA patients with a moderate to high STR have a 2- to 3-fold increased likelihood of responding according to ACR50 criteria.

AB - OBJECTIVE: To study the impact of swollen to tender joint count ratio (STR) and other baseline characteristics on treatment response to a first course of anti-tumor necrosis factor (anti-TNF) therapy in rheumatoid arthritis (RA) patients.METHODS: Patients with RA initiating their first course of anti-TNF treatment were included in a structured clinical followup protocol. Based on pragmatic thresholds and plausibility, patients were categorized as having low (STR <0.5), moderate (0.5 ≤ STR ≤ 1.0), or high (STR >1.0) joint count ratios. The data were collected and followed during the period of March 1999 through December 2010.RESULTS: A total of 2,507 patients were included in the study (median age 56 years, 78% women). Of these patients, 344 (14%) had a low STR, 1,180 (47%) had a moderate STR, and 983 (39%) had a high STR. According to these STR thresholds, 23% of patients (95% confidence interval [95% CI] 18-29%) with low, 39% (95% CI 35-43%) with moderate, and 40% (95% CI 36-44%) with high STR achieved the American College of Rheumatology criteria for 50% improvement (ACR50) response at 6 months after initiation. Correlation tests showed that STR was associated with ACR50 response independent of both swollen and tender joint counts. Logistic regression analysis consistently showed that moderate STR, high STR, not using prednisolone, high baseline Disease Activity Score in 28 joints, and low baseline Health Assessment Questionnaire scores were significantly associated with favorable ACR50 response with odds ratios of 1.93 (P < 0.01), 2.82 (P < 0.01), 0.65 (P < 0.01), 1.49 (P < 0.01), and 0.47 (P < 0.01), respectively.CONCLUSION: STR is a new and feasible predictor of treatment response in RA. RA patients with a moderate to high STR have a 2- to 3-fold increased likelihood of responding according to ACR50 criteria.

KW - Antirheumatic Agents

KW - Arthritis, Rheumatoid

KW - Chi-Square Distribution

KW - Disability Evaluation

KW - Feasibility Studies

KW - Female

KW - Follow-Up Studies

KW - Glucocorticoids

KW - Humans

KW - Joints

KW - Logistic Models

KW - Male

KW - Middle Aged

KW - Multivariate Analysis

KW - Odds Ratio

KW - Predictive Value of Tests

KW - Prednisolone

KW - Proportional Hazards Models

KW - Questionnaires

KW - ROC Curve

KW - Registries

KW - Severity of Illness Index

KW - Sweden

KW - Time Factors

KW - Treatment Outcome

KW - Tumor Necrosis Factor-alpha

U2 - 10.1002/acr.22107

DO - 10.1002/acr.22107

M3 - Journal article

VL - 66

SP - 173

EP - 179

JO - Arthritis Care & Research

JF - Arthritis Care & Research

SN - 2151-464X

IS - 2

ER -

ID: 44658953