Prediction of DAS28-ESR remission at 6 months by baseline variables in patients with rheumatoid arthritis treated with etanercept in Japanese population.
We tried to determine which baseline variables are responsible for remission induction at 6 months in unselected rheumatoid arthritis (RA) patients of Japanese population treated with etanercept. One hundred forty-one patients with RA who were administered etanercept were registered. Thirty-four patients were started on etanercept monotherapy, 60 patients on cotherapy with methotrexate (MTX) (MTX cotherapy), and 47 patients on cotherapy with other non-MTX nonbiologic disease-modifying antirheumatic drugs (DMARDs) (non-MTX cotherapy). None of the patients were treated with both MTX and non-MTX nonbiologic DMARDs at entry. Outcome was set as achievement of disease activity score 28 (DAS28)-ESR remission at 6 months. We examined association of gender, DAS at baseline, MTX cotherapy at baseline, non-MTX cotherapy at baseline, and prednisolone use at baseline with achievement of remission at 6 months by logistic regression analysis. All subjects were classified as having high (N = 109) or moderate disease activity (N = 32) at entry. One hundred twenty out of 141 patients (85.1%) continued treatment with etanercept at 6 months. Continuation rate was statistically higher in MTX cotherapy (93.3%) compared with etanercept monotherapy (73.5%), and tended to be higher than with non-MTX cotherapy (85.1%). Logistic regression analysis identified that MTX cotherapy at entry and moderate disease activity at entry were independent variables for remission induction at 6 months. Accordingly, DAS28-ESR at 6 months was significantly lower with MTX cotherapy as compared with etanercept monotherapy or non-MTX cotherapy. To a lesser extent, DAS28-ESR with non-MTX cotherapy at 6 months was lower than with etanercept monotherapy. In this study of unselected patients, use of MTX and moderate disease activity at entry were associated with higher likelihood of response to etanercept. Non-MTX nonbiologic DMARDs may be an alternative in RA patients administrated etanercept who are intolerant to MTX.
Iwamoto
Naoki
N
Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
Kawakami
Atsushi
A
Fujikawa
Keita
K
Aramaki
Toshiyuki
T
Kawashiri
Shin-Ya
SY
Tamai
Mami
M
Arima
Kazuhiko
K
Ichinose
Kunihiro
K
Kamachi
Makoto
M
Yamasaki
Satoshi
S
Nakamura
Hideki
H
Nakashima
Munetoshi
M
Mizokami
Akinari
A
Goto
Akiko
A
Fukuda
Takaaki
T
Matsuoka
Naoki
N
Ueki
Yukitaka
Y
Tsukada
Toshiaki
T
Migita
Kiyoshi
K
Shoumura
Fumiko
F
Kawabe
Yojiro
Y
Shibatomi
Kazutaka
K
Mine
Masanobu
M
Ida
Hiroaki
H
Origuchi
Tomoki
T
Aoyagi
Kiyoshi
K
Eguchi
Katsumi
K
D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001799:Blood Sedimentation; D004359:Drug Therapy, Combination; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D007564:Japan; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D010349:Patient Compliance; D011237:Predictive Value of Tests; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D012044:Regression Analysis; D012074:Remission Induction; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome
D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept; D008727:Methotrexate