Current tumor necrosis factor-alpha inhibitor use is associated with a higher probability of remissions in patients with rheumatoid arthritis.
OBJECTIVE
To determine if current tumor necrosis factor-alpha (TNF-alpha) inhibitor use is associated with a higher probability of remission than non-use in patients with rheumatoid arthritis (RA).


METHODS
Clinical and demographic data were collected from 322 patients with RA during regularly scheduled clinic visits. Current and past medications were recorded. Disease activity status (remission or not) was determined using American College of Rheumatology preliminary criteria for clinical remission of RA. A logistic regression analysis was used to calculate crude and adjusted odds ratios (OR) for remission for current TNF-alpha inhibitor users versus non-users. Multivariate analysis included age, gender, race, disease duration, use of nonsteroidal antiinflammatory drugs (NSAID), prednisone dosage, and numbers of previously used disease modifying antirheumatic drugs (DMARD).


RESULTS
Of the 111 patients enrolled in the study who were users of TNF-alpha inhibitors, 25.2% were found to be in clinical remission. Of the 211 patients who were non-users, 14.7% were in clinical remission. The unadjusted OR for remission in TNF-alpha inhibitor users was 1.96 (95% confidence interval, CI: 1.10 to 3.48). The adjusted OR was 2.74 (95% CI: 1.40 to 5.34).


CONCLUSIONS
Cross-sectional observations from an outpatient arthritis clinic found a significantly higher remission rate in patients with RA taking a TNF-alpha inhibitor compared to non-users.
Liang
George C
GC
Department of Medicine, Multidisciplinary Clinical Research Center in Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. gcliang@northwestern.edu
Cordero
Magaly
M
Dyer
Alan
A
Chang
Rowland W
RW
D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000188:drug therapy*; D015331:Cohort Studies; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010147:Pain Measurement; D011336:Probability; D016059:Range of Motion, Articular / Q000187:drug effects / Q000502:physiology; D020127:Recovery of Function / Q000187:drug effects; D012016:Reference Values; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000627:therapeutic use*
D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha