| Thresholds in disease activity for switching biologics in ra patients: Experience from a large United States cohort. | |
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MedLine Citation:
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PMID: 21954144 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: The study aims to examine the threshold in disease activity associated with switching biologic treatment regimens in RA patients in real-world clinical practice. METHODS: Using data from a prospective observational North American cohort of RA patients through 12/30/2009, patients who initiated a new anti-TNF agent with ≥ 6 months of follow-up were identified. Patients were classified as switchers or maintainers depending on whether they continued their anti-TNF treatment or switched (including discontinuation) within 12 months. Level of disease activity measured by CDAI and DAS28 at time of switch (corresponding follow-up visit for maintainers) was examined and random effect multivariable logistic regression was used to adjust for covariates. RESULTS: Mean age and RA duration among 1,549 eligible patients were 56.1 and 9.6 years, 80% were women, 62% were initiating their 1(st) biologic and 30% 2(nd) . At time of switch, the median DAS28 and CDAI were 3.1 and 8.4 among maintainers, and 4.0 and 15.2 among switchers. Maintainers also experienced a greater amount of reduction in disease activity compared with switchers (CDAI: -7.7 vs. -2.3; DAS28: -1.1 vs. -0.3). The threshold to switch decreased over calendar time, with the greatest amount of reduction observed among patients with moderate disease activity. CONCLUSION: On average, physicians and patients were willing to continue biologic treatment for patients who are at or near low disease activity. The threshold to switch decreased over time, especially among partial responders. © 2011 by the American College of Rheumatology. |
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Authors:
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Jie Zhang; Ying Shan; George Reed; Joel Kremer; Jeffrey D Greenberg; Scott Baumgartner; Jeffrey R Curtis |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-9-27 |
Journal Detail:
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Title: Arthritis care & research Volume: - ISSN: 2151-4658 ISO Abbreviation: - Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-9-28 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101518086 Medline TA: Arthritis Care Res (Hoboken) Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 by the American College of Rheumatology. |
Affiliation:
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Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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