Predictive factors for achieving low disease activity at 52 weeks after switching from tumor necrosis factor inhibitors to abatacept: results from a multicenter observational cohort study of Japanese patients
Predictive factors for achieving low disease activity at 52 weeks after switching from tumor necrosis factor inhibitors to abatacept: results from a multicenter observational cohort study of Japanese patients
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从肿瘤坏死因子抑制剂转用阿巴西普后 52 周实现低疾病活动度的预测因素：日本患者多中心观察性队列研究的结果
DOI：
10.1007/s10067-015-3135-3
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发表时间：
2016
影响因子：
3.4
通讯作者：
As
中科院分区：
文献类型：
--
作者：
Kojima;T.;Takahashi;N.;Kaneko;A.;Kida;D.;Hirano;Y.;Fujibayashi;T.;Yabe;Y.;Takagi;H.;Oguchi;T.;Miyake;H.;Kato;T.;Watanabe;T.;Hayashi;M.;Shioura;T.;Kanayama;Y.;Funahashi;K.;Asai;S.;Yoshioka;Y.;Terabe;K.;Takemoto;T.;As
本研究旨在确定类风湿性关节炎 (RA) 患者从肿瘤坏死因子抑制剂 (TNFis) 转用阿巴西普 (ABT) 时实现低疾病活动度 (LDA) 的预测因素。在多中心观察性鹤舞生物制品通讯登记处 (TBCR) 登记的患者参与了本研究。通过单变量和多变量逻辑回归分析确定每个时间点 LDA 成就的预测因素。使用受试者工作特征 (ROC) 曲线探讨了 28 点计数疾病活动评分 (DAS28)-C 反应蛋白 (CRP) 和 ΔDAS28-CRP 从基线到 24 周的 52 周 LDA 成就的截止值。截至 2013 年，在登记的 2771 名 RA 患者中，选择了 76 名具有中度或高度疾病活动度的患者。 26% 的患者达到了 LDA。多变量分析证实，12 周时的 DAS28-CRP 和从基线到 12 周的 ΔDAS28-CRP 是 52 周时 LDA 实现的独立因素 [比值比 (OR) 0.26，95% 置信区间 (CI) (0.12–0.56)，OR 0.25，95% CI (0.11–0.57)]。 52 周时 LDA 在 12 周时的 DAS28-CRP 和从基线到 12 周的 ΔDAS28-CRP 的最佳截止值分别为 3.9（敏感性 0.85，特异性 0.78）和 -0.97（敏感性 0.70，特异性 0.70）。在 12 周时达到这两个临界值的患者中，有 71% 在 52 周时达到了 LDA。我们的研究结果表明，长达 12 周的临床病程对于预测从 TNFis 转为 ABT 时的长期结果非常重要。
This study aimed to identify predictive factors for achieving low disease activity (LDA) in rheumatoid arthritis (RA) patients switching from tumor necrosis factor inhibitors (TNFis) to abatacept (ABT). Patients who were registered in the multicenter observational Tsurumai Biologics Communication Registry (TBCR) were enrolled in this study. Predictive factors for LDA achievement at each time point were determined by univariate and multivariate logistic regression analyses. The cutoffs of 28-point count Disease Activity Score (DAS28)-C-reactive protein (CRP) and ΔDAS28-CRP from baseline up to 24 weeks for LDA achievement at 52 weeks were explored using receiver operating characteristic (ROC) curves. Of 2771 RA patients registered until 2013, 76 with moderate or high disease activity were selected. Twenty-six percent of the patients achieved LDA. Multivariate analysis confirmed that DAS28-CRP at 12 weeks and ΔDAS28-CRP from baseline to 12 weeks were independent factors for LDA achievement at 52 weeks [odds ratio (OR) 0.26, 95 % confident interval (CI) (0.12–0.56), OR 0.25, 95 % CI (0.11–0.57), respectively]. The best cutoff values of DAS28-CRP at 12 weeks and ΔDAS28-CRP from baseline to 12 weeks for LDA at 52 weeks were 3.9 (sensitivity 0.85, specificity 0.78) and −0.97 (sensitivity 0.70, specificity 0.70), respectively. Seventy-one percent of patients who achieved both of these cutoff values at 12 weeks achieved LDA at 52 weeks. Our findings suggest that the clinical course up to 12 weeks is important for predicting long-term outcomes when switching from TNFis to ABT.