Document Detail


Thresholds in disease activity for switching biologics in ra patients: Experience from a large United States cohort.
MedLine Citation:
PMID:  21954144     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.
Authors:
Jie Zhang; Ying Shan; George Reed; Joel Kremer; Jeffrey D Greenberg; Scott Baumgartner; Jeffrey R Curtis
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-27
Journal Detail:
Title:  Arthritis care & research     Volume:  -     ISSN:  2151-4658     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101518086     Medline TA:  Arthritis Care Res (Hoboken)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 by the American College of Rheumatology.
Affiliation:
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL.
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