title: Impact of patient and disease characteristics on therapeutic success during adalimumab treatment of patients with rheumatoid arthritis: data from a German noninterventional observational study.
abstract: The objective of this study was to use data from a noninterventional study to evaluate the effectiveness of adalimumab in rheumatoid arthritis (RA) patients during routine clinical practice and to explore the potential impact of patient and disease characteristics in response to adalimumab therapy. A total of 2,625 RA patients with specified data at baseline (prior to initiating adalimumab treatment) and 12 months entered this study between April 2003 and March 2009. We evaluated response to adalimumab therapy and conducted stepwise regression and subgroup analyses of factors influencing therapeutic response. During the 1-year adalimumab treatment period, disease activity decreased from a baseline mean disease activity score-28 joints (DAS28) of 5.9-3.9, while functional capacity improved from 59.0 to 68.4 Funktionsfragebogen Hannover (FFbH) percentage points. In multivariate regression models, high baseline DAS28 was the strongest positive predictor for decrease in disease activity, and high baseline functional capacity was associated with reduced gains in functional capacity. Male gender was a positive predictor of therapeutic response for both disease activity and functional capacity, while older age and multiple previous biologics were associated with a reduced therapeutic response. Subset analyses provided further support for the impact of baseline DAS28, FFbH, and prior biologic therapy on therapeutic response during treatment. We conclude that treatment with adalimumab leads to decreased disease activity and improved function during routine clinical practice. Patients with high disease activity and low functional capacity are particularly benefitted by adalimumab therapy.
authors.affiliation: Rheumatologie/Klinische Immunologie, Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik II, Oberdürrbacherstr. 6, 97080 Würzburg, Germany. Kleinert_S@klinik.uni-wuerzburg.de
authors.forename: Stefan
authors.initials: S
authors.lastname: Kleinert
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Tony
authors.forename: Andreas
authors.initials: A
authors.lastname: Krause
authors.forename: Martin
authors.initials: M
authors.lastname: Feuchtenberger
authors.forename: Siegfried
authors.initials: S
authors.lastname: Wassenberg
authors.forename: Constanze
authors.initials: C
authors.lastname: Richter
authors.forename: Ekkehard
authors.initials: E
authors.lastname: Röther
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Spieler
authors.forename: Holger
authors.initials: H
authors.lastname: Gnann
authors.forename: Bianca M
authors.initials: BM
authors.lastname: Wittig
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000367:Age Factors; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000208:ethnology*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab