Association between concomitant csDMARDs and clinical response to TNF inhibitors in overweight patients with axial spondyloarthritis.
Adalimumab
/ therapeutic use
Adult
Antirheumatic Agents
/ chemical synthesis
Body Mass Index
Drug Therapy, Combination
Female
Humans
Infliximab
/ therapeutic use
Logistic Models
Male
Middle Aged
Overweight
/ complications
Prospective Studies
Remission Induction
Spondylarthritis
/ complications
Tumor Necrosis Factor Inhibitors
/ therapeutic use
Axial spondyloarthritis
Body mass index
Clinical response
Concomitant csDMARDs
TNF inhibitors
Journal
Arthritis research & therapy
ISSN: 1478-6362
Titre abrégé: Arthritis Res Ther
Pays: England
ID NLM: 101154438
Informations de publication
Date de publication:
20 02 2019
20 02 2019
Historique:
received:
11
10
2018
accepted:
11
02
2019
entrez:
22
2
2019
pubmed:
23
2
2019
medline:
9
4
2020
Statut:
epublish
Résumé
The aim of our study was to investigate the influence of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) and body mass index (BMI) on circulating drug levels and clinical response to tumour necrosis factor inhibitor (TNFi) therapy in axial spondyloarthritis (axSpA) patients. Prospective observational study during 1 year with 2 cohorts (Madrid and Amsterdam) including 180 axSpA patients treated with standard doses of infliximab or adalimumab. Patients were stratified by BMI, being 78 (43%) normal weight (18.5-24.9 kg/m Seventy-nine patients (44%) received concomitant csDMARDs. The administration of concomitant csDMARDs (OR 3.82; 95% CI 1.06-13.84) and being normal weight (OR 18.38; 95% CI 2.24-150.63) were independently associated with serum TNFi drug persistence. Additionally, the use of concomitant csDMARDs contributed positively to achieve clinical response (OR 7.86; 95% CI 2.39-25.78) and remission (OR 4.84; 95% CI 1.09-21.36) in overweight/obese patients, but no association was found for normal-weight patients (OR 1.10; 0.33-3.58). The use of concomitant csDMARDs with TNFi may increase the probability of achieving clinical response in overweight/obese axSpA patients. Further research studies including larger cohorts of patients need to be done to confirm it.
Sections du résumé
BACKGROUND
The aim of our study was to investigate the influence of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) and body mass index (BMI) on circulating drug levels and clinical response to tumour necrosis factor inhibitor (TNFi) therapy in axial spondyloarthritis (axSpA) patients.
METHODS
Prospective observational study during 1 year with 2 cohorts (Madrid and Amsterdam) including 180 axSpA patients treated with standard doses of infliximab or adalimumab. Patients were stratified by BMI, being 78 (43%) normal weight (18.5-24.9 kg/m
RESULTS
Seventy-nine patients (44%) received concomitant csDMARDs. The administration of concomitant csDMARDs (OR 3.82; 95% CI 1.06-13.84) and being normal weight (OR 18.38; 95% CI 2.24-150.63) were independently associated with serum TNFi drug persistence. Additionally, the use of concomitant csDMARDs contributed positively to achieve clinical response (OR 7.86; 95% CI 2.39-25.78) and remission (OR 4.84; 95% CI 1.09-21.36) in overweight/obese patients, but no association was found for normal-weight patients (OR 1.10; 0.33-3.58).
CONCLUSIONS
The use of concomitant csDMARDs with TNFi may increase the probability of achieving clinical response in overweight/obese axSpA patients. Further research studies including larger cohorts of patients need to be done to confirm it.
Identifiants
pubmed: 30786913
doi: 10.1186/s13075-019-1849-3
pii: 10.1186/s13075-019-1849-3
pmc: PMC6383284
doi:
Substances chimiques
Antirheumatic Agents
0
Tumor Necrosis Factor Inhibitors
0
Infliximab
B72HH48FLU
Adalimumab
FYS6T7F842
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
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