Low rates of biologic-free clinical disease activity index remission maintenance after biologic disease-modifying anti-rheumatic drug discontinuation while in remission in a Japanese multicentre rheumatoid arthritis registry.

Rheumatology
Kazuki YoshidaShigeto Tohma

Abstract

To examine in detail the outcomes of biologic DMARD (bDMARD) discontinuation while in remission occurring in daily clinical practice settings. We examined a multicentre longitudinal registry of RA patients. We utilized data from the NinJa multicenter registry in Japan. Patients who used bDMARDs and had one or more successive visits in remission (defined by the clinical disease activity index (CDAI) ≤2.8) before discontinuation were included. The outcome of failing bDMARD-free disease control was defined as a composite of the following: re-use of bDMARDs, intensification of non-biologic DMARDs or of oral glucocorticoids, or loss of CDAI remission. Among 1037 patients who initially achieved remission on bDMARDs, 46 patients discontinued bDMARDs while remaining in remission. Of these 46 subjects, 41 (89.1%) were female, the median disease duration was 6.0 years and 31 (70.5%) had reported radiographical erosions. At the baseline, 27 (58.7%) used MTX and 19 (41.3%) used oral glucocorticoids. The bDMARD-free remission failure rate was estimated to be 67.4% at 1 year and 78.3% at 2 years. Loss of remission and reuse of bDMARDs were the more common reasons for failure. Lower CDAI within the remission range was associated with fewer fa...Continue Reading

References

Apr 14, 2009·Joint, Bone, Spine : Revue Du Rhumatisme·Olivier BrocqLiana Euller-Ziegler
Jun 1, 2013·Annals of the Rheumatic Diseases·Kazuki YoshidaDaniel H Solomon
Oct 26, 2013·Clinical Therapeutics·Iris Navarro-MillánJeffrey R Curtis
Nov 6, 2014·The New England Journal of Medicine·Paul EmeryBonnie Vlahos

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Citations

Oct 21, 2016·Expert Review of Clinical Pharmacology·Fabiola AtzeniMarcello Govoni
Mar 4, 2017·Rheumatology and Therapy·Lise M VerhoefAlfons A den Broeder
Jun 3, 2016·The Journal of Rheumatology·Kazuki YoshidaDaniel H Solomon

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