Document Detail

Prediction of response to disease modifying antirheumatic drugs in rheumatoid arthritis.
MedLine Citation:
PMID:  20478729     Owner:  NLM     Status:  In-Data-Review    
AIM: To investigate potential predictors of response to conventional DMARDs in RA.
METHODS: Study design - 6-month follow-up prospective study.
PARTICIPANTS: RA patients with active disease. INTERVENTION AND FOLLOW-UP: Introduction of one DMARD. Response to treatment evaluated at 6 months (ACR20 criteria).
ANALYSIS: Potential predictors of response, patients' demographics, disease activity, percentages of PBMC subsets expressing P-gp, serum IL-1β, IL-6, IL-8, IL-10, IL-12, TNF-α levels, were evaluated using univariate and multivariate logistic regression analysis. ROC curve analyses were performed in order to obtain thresholds allowing the prediction of response.
RESULTS: Forty-two patients (mean age=57±13 years, mean disease duration=5.4±7.2 years) were included. MTX was given to 30. The response to therapy was predicted by the baseline serum level of TNF-α (mean=30.2 pg/ml±18 in non-responders vs. 11.9 pg/ml±11.2 in responders). The threshold, which predicted with the best accuracy the response to treatment, was 20.1 pg/ml (sensitivity, specificity, positive and negative predictive values of 75, 78.9, 83.3, and 69.2%, respectively; AUC=80.3%, 95% CI=62.8-97.7%). Similar results were obtained in the subgroups of patients treated with MTX and patients with early RA of less than 3 years duration.
CONCLUSION: In the present work, the serum concentration of TNF-α was related to further response to DMARDs. Other works are needed for confirmation and to assess whether such biomarker could be used to predict the response to DMARDs at the individual level.
Jean-Francis Maillefert; Xavier Puéchal; Géraldine Falgarone; Gérard Lizard; Paul Ornetti; Elisabeth Solau; Virginie Legré; Frédéric Lioté; Jean Sibilia; Jacques Morel; Marc Maynadié;
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Publication Detail:
Type:  Journal Article     Date:  2010-05-15
Journal Detail:
Title:  Joint, bone, spine : revue du rhumatisme     Volume:  77     ISSN:  1778-7254     ISO Abbreviation:  Joint Bone Spine     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100938016     Medline TA:  Joint Bone Spine     Country:  France    
Other Details:
Languages:  eng     Pagination:  558-63     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.
Inserm U887, Department of rheumatology, hôpital Général, Dijon University Hospital, University of Burgundy, 3, rue du Fb-Raines, 21078 Dijon, France.
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