Predictors of response to TNF inhibitors in rheumatoid arthritis: an individual patient data pooled analysis of randomised controlled trials.
Predictors of response to TNF inhibitors in rheumatoid arthritis: an individual patient data pooled analysis of randomised controlled trials.
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DOI：
10.1136/rmdopen-2021-001882
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发表时间：
2021-11
期刊：
影响因子：
6.2
通讯作者：
Bejan-Angoulvant T
中科院分区：
文献类型：
--
作者：
Law-Wan J;Sparfel MA;Derolez S;Azzopardi N;Goupille P;Detert J;Mulleman D;Bejan-Angoulvant T
确定与类风湿关节炎（RA）患者对肿瘤坏死因子抑制剂（TNFi）反应性相关的患者特征。从29项随机对照试验（RCT）中获得了个体患者数据，这些试验评价了TNFi与安慰剂或常规治疗相比的疗效。根据以下基线特征在亚组中评估对治疗的反应：吸烟状况、体力活动、性别、年龄、体重指数、自身抗体谱、疾病持续时间、由28个关节上的疾病活动性评分（DAS 28）（C反应蛋白（CRP））>5.1定义的高初始疾病活动性。主要结局是DAS 28（CRP）从基线至6个月变化的治疗组间差异。次要终点是治疗组间6个月内测量的最终DAS 28（CRP）差异和6个月内EULAR反应标准。然后使用随机效应模型，通过Mantel-Haenszel方法合并每个RCT的数据。还分别在两个数据共享平台上进行了线性元回归以支持结果。分析了来自29项RCT的11617例患者的个体数据。直到6个月，在肥胖患者中观察到显著更高的EULAR无应答率（OR 0.52 vs非肥胖患者0.36，p=0.01）。对7457名患者进行的多变量回归模型表明，接受TNFi治疗的患者的最终DAS 28（CRP）在疾病持续时间的每一年下降0.02（p<0.001），基线DAS 28（CRP）>5.1的患者下降0.21（p<0.001）。在RA中，对TNFi更有反应的患者是非肥胖的，具有长的疾病持续时间并且具有高的初始疾病活动性。
To identify patient characteristics associated with responsiveness to tumour necrosis factor inhibitors (TNFi) in rheumatoid arthritis (RA). Individual patient data from 29 randomised controlled trials (RCTs) evaluating the efficacy of a TNFi versus placebo or conventional therapy were obtained. Response to treatment was assessed in subgroups according to the following baseline characteristics: smoking status, physical activity, sex, age, body mass index, autoantibody profile, disease duration, high initial disease activity defined by Disease Activity Score on 28 joints (DAS28)(C reactive protein (CRP)) >5.1. The primary outcome was the between-treatment group difference in DAS28(CRP) change from baseline to 6 months. The secondary endpoints were the between-treatment group difference in final DAS28(CRP) measured until 6 months and EULAR response criteria until 6 months. Data from each RCT were then pooled by the Mantel-Haenszel method using a random effects model. A linear metaregression was also carried out on two data-sharing platforms separately to support the results. Individual data of 11 617 patients from 29 RCTs were analysed. Until 6 months, a significantly higher EULAR non-response rate was observed in obese patients (OR 0.52 vs 0.36 for non-obese, p=0.01). A multivariable regression model performed on 7457 patients indicated that patients treated by TNFi had a final DAS28(CRP) decreased by 0.02 for each year of disease duration (p<0.001), and a 0.21 decreased for patients with a baseline DAS28(CRP) >5.1 (p<0.001). In RA, patients who are more responsive to TNFi are those who are non-obese, have a long disease duration and have a high initial disease activity.
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影响因子：
--
作者：
Keystone, EC;Kavanaugh, AF;Chartash, EK
通讯作者：
Chartash, EK
体重对风湿性疾病患者最小疾病活性的影响：系统评价和荟萃分析。
影响因子：
4.9
作者：
Lupoli R;Pizzicato P;Scalera A;Ambrosino P;Amato M;Peluso R;Di Minno MN
通讯作者：
Di Minno MN
类风湿关节炎的流行病学和遗传学。
DOI：
10.1186/ar578
发表时间：
2002
期刊：
Arthritis research
影响因子：
--
作者：
Silman AJ;Pearson JE
通讯作者：
Pearson JE
影响因子：
5.5
作者：
Hyrich, K. L.;Watson, K. D.;Symmons, D. P. M.
通讯作者：
Symmons, D. P. M.
影响因子：
--
作者：
Hetland, Merete Lund;Christensen, Ib Jarle;Ostergaard, Mikkel
通讯作者：
Ostergaard, Mikkel