title: High rate of disease remission in moderate rheumatoid arthritis on etanercept therapy: data from GISEA, the Italian biologics register.
abstract: The aim of this study was to evaluate the clinical outcomes of etanercept in rheumatoid arthritis (RA) patients with moderate or severe disease activity. We analyzed data from the Italian biologics register Gruppo Italiano Studio Early Arthritides (GISEA) to investigate the rate of disease remission and functional improvement, based on the 28-Joint Disease Activity Score (DAS28) and the (Health Assessment Questionnaire (HAQ) score in RA patients with moderate or severe disease activity beginning etanercept therapy. Disease was defined as severe (H-RA) with DAS28 ≥5.1 and moderate (M-RA) with DAS28 ≥3.2 to 5.1 at baseline. Patients were considered in remission if DAS28 was ≤2.6, and HAQ ≤0.5 defined normal function. We enrolled 953 RA patients, 320 with M-RA and 633 H-RA. Age and disease duration were similar in the two cohorts, but H-RA patients had significantly more comorbidities (p < 0.01) and took significantly more disease-modifying antirheumatic drugs (p < 0.001) than M-RA patients. After 1 year, the percentage of patients achieving disease remission and normal function (DAS28 ≤2.6 plus HAQ ≤0.5) was higher in M-RA (21.4 %) than in H-RA patients (14.8 %, p = 0.007), regardless of the disease duration. Additionally, female gender (p = 0.006) and H-RA class (p = 0.002) negatively predicted disease remission at 1 year. However, the drug survival rate did not differ between the two subsets. This study confirms that etanercept was effective in the treatment of active RA, but best response, in terms of disease remission and normal function ability, was greater and easier to attain in M-RA patients. These findings may aid clinicians to choose the best strategy to treat RA.
authors: Interdisciplinary Department of Medicine, Rheumatology Unit, Policlinico, Piazza G. Cesare 11, 70124, Bari, Italy, florenzo.iannone@uniba.it.
authors: Florenzo
authors: F
authors: Iannone
authors: Elisa
authors: E
authors: Gremese
authors: Gaia
authors: G
authors: Gallo
authors: Piercarlo
authors: P
authors: Sarzi-Puttini
authors: Costantino
authors: C
authors: Botsios
authors: Francesco
authors: F
authors: Trotta
authors: Stefania
authors: S
authors: Gasperini
authors: Mauro
authors: M
authors: Galeazzi
authors: Silvano
authors: S
authors: Adami
authors: Fabrizio
authors: F
authors: Cantini
authors: Marco
authors: M
authors: Sebastiani
authors: Roberto
authors: R
authors: Gorla
authors: Antonio
authors: A
authors: Marchesoni
authors: Annarita
authors: A
authors: Giardina
authors: Rosario
authors: R
authors: Foti
authors: Angiola
authors: A
authors: Mele
authors: Eleonora
authors: E
authors: Bruschi
authors: Gianluca
authors: G
authors: Bagnato
authors: Gian Luca
authors: GL
authors: Erre
authors: Giovanni
authors: G
authors: Lapadula
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001688:Biological Products / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D000068800:Etanercept; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage*; D007558:Italy; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D011446:Prospective Studies; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage*; D012042:Registries; D012074:Remission Induction; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products; D005938:Glucocorticoids; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept; D008727:Methotrexate
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