Multi-biomarker disease activity score as a predictor of disease relapse in patients with rheumatoid arthritis stopping TNF inhibitor treatment.
Successfully stopping or reducing treatment for patients with rheumatoid arthritis (RA) in low disease activity (LDA) may improve cost-effectiveness of care. We evaluated the multi-biomarker disease activity (MBDA) score as a predictor of disease relapse after discontinuation of TNF inhibitor (TNFi)...
Main Authors: | , , , , , , , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Public Library of Science (PLoS)
2018-01-01
|
Series: | PLoS ONE |
Online Access: | http://europepmc.org/articles/PMC5965880?pdf=render |
id |
doaj-931061a4243b42b79f19e460a8f6321b |
---|---|
record_format |
Article |
spelling |
doaj-931061a4243b42b79f19e460a8f6321b2020-11-25T02:08:05ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01135e019242510.1371/journal.pone.0192425Multi-biomarker disease activity score as a predictor of disease relapse in patients with rheumatoid arthritis stopping TNF inhibitor treatment.Marjan Ghiti MoghadamFemke B G Lamers-KarnebeekHarald E VonkemanPeter M Ten KloosterJanneke TekstraAnnemarie M SchilderHenk VisserEric H SassoDavid ChernoffWillem F LemsDirk-Jan van SchaardenburgRobert LandeweHein J Bernelot MoensTimothy R D J RadstakePiet L C M van RielMart A F J van de LaarTim L JansenDutch National POET CollaborationSuccessfully stopping or reducing treatment for patients with rheumatoid arthritis (RA) in low disease activity (LDA) may improve cost-effectiveness of care. We evaluated the multi-biomarker disease activity (MBDA) score as a predictor of disease relapse after discontinuation of TNF inhibitor (TNFi) treatment.439 RA patients who were randomized to stop TNFi treatment in the POET study were analyzed post-hoc. Three indicators of disease relapse were assessed over 12 months: 1) restarting TNFi treatment, 2) escalation of any DMARD therapy and 3) physician-reported flare. MBDA score was assessed at baseline. Associations between MBDA score and disease relapse were examined using univariate analysis and multivariate logistic regression.At baseline, 50.1%, 35.3% and 14.6% of patients had low (<30), moderate (30-44) or high (>44) MBDA scores. Within 12 months, 49.9% of patients had restarted TNFi medication, 59.0% had escalation of any DMARD and 57.2% had ≥1 physician-reported flare. MBDA score was associated with each indicator of relapse. At least one indicator of relapse was observed in 59.5%, 68.4% and 81.3% of patients with low, moderate or high MBDA scores, respectively (P = 0.004). Adjusted for baseline DAS28-ESR, disease duration, BMI and erosions, high MBDA scores were associated with increased risk for restarting TNFi treatment (OR = 1.85, 95% CI 1.00-3.40), DMARD escalation (OR = 1.99, 95% CI 1.01-3.94) and physician-reported flare (OR = 2.00, 95% 1.06-3.77).For RA patients with stable LDA who stopped TNFi, a high baseline MBDA score was independently predictive of disease relapse within 12 months. The MBDA score may be useful for identifying patients at risk of relapse after TNFi discontinuation.http://europepmc.org/articles/PMC5965880?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Marjan Ghiti Moghadam Femke B G Lamers-Karnebeek Harald E Vonkeman Peter M Ten Klooster Janneke Tekstra Annemarie M Schilder Henk Visser Eric H Sasso David Chernoff Willem F Lems Dirk-Jan van Schaardenburg Robert Landewe Hein J Bernelot Moens Timothy R D J Radstake Piet L C M van Riel Mart A F J van de Laar Tim L Jansen Dutch National POET Collaboration |
spellingShingle |
Marjan Ghiti Moghadam Femke B G Lamers-Karnebeek Harald E Vonkeman Peter M Ten Klooster Janneke Tekstra Annemarie M Schilder Henk Visser Eric H Sasso David Chernoff Willem F Lems Dirk-Jan van Schaardenburg Robert Landewe Hein J Bernelot Moens Timothy R D J Radstake Piet L C M van Riel Mart A F J van de Laar Tim L Jansen Dutch National POET Collaboration Multi-biomarker disease activity score as a predictor of disease relapse in patients with rheumatoid arthritis stopping TNF inhibitor treatment. PLoS ONE |
author_facet |
Marjan Ghiti Moghadam Femke B G Lamers-Karnebeek Harald E Vonkeman Peter M Ten Klooster Janneke Tekstra Annemarie M Schilder Henk Visser Eric H Sasso David Chernoff Willem F Lems Dirk-Jan van Schaardenburg Robert Landewe Hein J Bernelot Moens Timothy R D J Radstake Piet L C M van Riel Mart A F J van de Laar Tim L Jansen Dutch National POET Collaboration |
author_sort |
Marjan Ghiti Moghadam |
title |
Multi-biomarker disease activity score as a predictor of disease relapse in patients with rheumatoid arthritis stopping TNF inhibitor treatment. |
title_short |
Multi-biomarker disease activity score as a predictor of disease relapse in patients with rheumatoid arthritis stopping TNF inhibitor treatment. |
title_full |
Multi-biomarker disease activity score as a predictor of disease relapse in patients with rheumatoid arthritis stopping TNF inhibitor treatment. |
title_fullStr |
Multi-biomarker disease activity score as a predictor of disease relapse in patients with rheumatoid arthritis stopping TNF inhibitor treatment. |
title_full_unstemmed |
Multi-biomarker disease activity score as a predictor of disease relapse in patients with rheumatoid arthritis stopping TNF inhibitor treatment. |
title_sort |
multi-biomarker disease activity score as a predictor of disease relapse in patients with rheumatoid arthritis stopping tnf inhibitor treatment. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2018-01-01 |
description |
Successfully stopping or reducing treatment for patients with rheumatoid arthritis (RA) in low disease activity (LDA) may improve cost-effectiveness of care. We evaluated the multi-biomarker disease activity (MBDA) score as a predictor of disease relapse after discontinuation of TNF inhibitor (TNFi) treatment.439 RA patients who were randomized to stop TNFi treatment in the POET study were analyzed post-hoc. Three indicators of disease relapse were assessed over 12 months: 1) restarting TNFi treatment, 2) escalation of any DMARD therapy and 3) physician-reported flare. MBDA score was assessed at baseline. Associations between MBDA score and disease relapse were examined using univariate analysis and multivariate logistic regression.At baseline, 50.1%, 35.3% and 14.6% of patients had low (<30), moderate (30-44) or high (>44) MBDA scores. Within 12 months, 49.9% of patients had restarted TNFi medication, 59.0% had escalation of any DMARD and 57.2% had ≥1 physician-reported flare. MBDA score was associated with each indicator of relapse. At least one indicator of relapse was observed in 59.5%, 68.4% and 81.3% of patients with low, moderate or high MBDA scores, respectively (P = 0.004). Adjusted for baseline DAS28-ESR, disease duration, BMI and erosions, high MBDA scores were associated with increased risk for restarting TNFi treatment (OR = 1.85, 95% CI 1.00-3.40), DMARD escalation (OR = 1.99, 95% CI 1.01-3.94) and physician-reported flare (OR = 2.00, 95% 1.06-3.77).For RA patients with stable LDA who stopped TNFi, a high baseline MBDA score was independently predictive of disease relapse within 12 months. The MBDA score may be useful for identifying patients at risk of relapse after TNFi discontinuation. |
url |
http://europepmc.org/articles/PMC5965880?pdf=render |
work_keys_str_mv |
AT marjanghitimoghadam multibiomarkerdiseaseactivityscoreasapredictorofdiseaserelapseinpatientswithrheumatoidarthritisstoppingtnfinhibitortreatment AT femkebglamerskarnebeek multibiomarkerdiseaseactivityscoreasapredictorofdiseaserelapseinpatientswithrheumatoidarthritisstoppingtnfinhibitortreatment AT haraldevonkeman multibiomarkerdiseaseactivityscoreasapredictorofdiseaserelapseinpatientswithrheumatoidarthritisstoppingtnfinhibitortreatment AT petermtenklooster multibiomarkerdiseaseactivityscoreasapredictorofdiseaserelapseinpatientswithrheumatoidarthritisstoppingtnfinhibitortreatment AT janneketekstra multibiomarkerdiseaseactivityscoreasapredictorofdiseaserelapseinpatientswithrheumatoidarthritisstoppingtnfinhibitortreatment AT annemariemschilder multibiomarkerdiseaseactivityscoreasapredictorofdiseaserelapseinpatientswithrheumatoidarthritisstoppingtnfinhibitortreatment AT henkvisser multibiomarkerdiseaseactivityscoreasapredictorofdiseaserelapseinpatientswithrheumatoidarthritisstoppingtnfinhibitortreatment AT erichsasso multibiomarkerdiseaseactivityscoreasapredictorofdiseaserelapseinpatientswithrheumatoidarthritisstoppingtnfinhibitortreatment AT davidchernoff multibiomarkerdiseaseactivityscoreasapredictorofdiseaserelapseinpatientswithrheumatoidarthritisstoppingtnfinhibitortreatment AT willemflems multibiomarkerdiseaseactivityscoreasapredictorofdiseaserelapseinpatientswithrheumatoidarthritisstoppingtnfinhibitortreatment AT dirkjanvanschaardenburg multibiomarkerdiseaseactivityscoreasapredictorofdiseaserelapseinpatientswithrheumatoidarthritisstoppingtnfinhibitortreatment AT robertlandewe multibiomarkerdiseaseactivityscoreasapredictorofdiseaserelapseinpatientswithrheumatoidarthritisstoppingtnfinhibitortreatment AT heinjbernelotmoens multibiomarkerdiseaseactivityscoreasapredictorofdiseaserelapseinpatientswithrheumatoidarthritisstoppingtnfinhibitortreatment AT timothyrdjradstake multibiomarkerdiseaseactivityscoreasapredictorofdiseaserelapseinpatientswithrheumatoidarthritisstoppingtnfinhibitortreatment AT pietlcmvanriel multibiomarkerdiseaseactivityscoreasapredictorofdiseaserelapseinpatientswithrheumatoidarthritisstoppingtnfinhibitortreatment AT martafjvandelaar multibiomarkerdiseaseactivityscoreasapredictorofdiseaserelapseinpatientswithrheumatoidarthritisstoppingtnfinhibitortreatment AT timljansen multibiomarkerdiseaseactivityscoreasapredictorofdiseaserelapseinpatientswithrheumatoidarthritisstoppingtnfinhibitortreatment AT dutchnationalpoetcollaboration multibiomarkerdiseaseactivityscoreasapredictorofdiseaserelapseinpatientswithrheumatoidarthritisstoppingtnfinhibitortreatment |
_version_ |
1724927681964802048 |