title: Disease activity early in treatment as a predictor of future low disease activity in RA patients treated with iguratimod.
abstract: OBJECTIVE
  This retrospective observational study aimed to examine the efficacy of iguratimod with and without concomitant methotrexate (MTX) and to estimate the adequate observational period for predicting low disease activity (LDA) achievement at 24 weeks in patients with rheumatoid arthritis (RA).
  
  
  METHODS
  All patients treated with iguratimod were registered in a Japanese multicenter registry. Multivariate analyses were performed to identify predictive factors for LDA achievement at 24 weeks. Receiver operating characteristic (ROC) curve analyses were performed to estimate the association of 28-joint disease activity score based on erythrocyte sedimentation rate (DAS28-ESR) at each time point with achievement of LDA at 24 weeks and determine a cut-off for DAS28-ESR.
  
  
  RESULTS
  A total of 123 patients were treated with iguratimod with (n = 65) or without (n = 58) MTX. Iguratimod therapy resulted in significant clinical improvement in both groups. Multivariate analysis revealed that DAS28-ESR at each time point was an independent significant predictor of LDA achievement at 24 weeks. Cut-off values of DAS28-ESR at 12 weeks based on ROC curves were 3.2 and 3.6 in patients with and without MTX, respectively.
  
  
  CONCLUSIONS
  Iguratimod was effective in RA patients in clinical practice. Our results suggest that 12 weeks may be a sufficient period to judge the medium-term efficacy of iguratimod in patients treated with and without MTX.
authors.affiliation: a Department of Orthopaedic Surgery and Rheumatology , Nagoya University Graduate School of Medicine , Aichi , Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yoshioka
authors.affiliation: a Department of Orthopaedic Surgery and Rheumatology , Nagoya University Graduate School of Medicine , Aichi , Japan.
authors.forename: Nobunori
authors.initials: N
authors.lastname: Takahashi
authors.affiliation: b Department of Orthopaedic Surgery and Rheumatology , Nagoya Medical Centre , Aichi , Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kaneko
authors.affiliation: c Department of Rheumatology , Toyohashi Municipal Hospital , Toyohashi , Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hirano
authors.affiliation: d Department of Orthopaedic Surgery , Toyota Kosei Hospital , Toyota , Japan.
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Kanayama
authors.affiliation: b Department of Orthopaedic Surgery and Rheumatology , Nagoya Medical Centre , Aichi , Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Kanda
authors.affiliation: e Department of Orthopaedic Surgery , Nagoya Central Hospital , Nagoya , Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Takagi
authors.affiliation: f Ito Orthopaedic Clinic , Nagoya , Japan.
authors.forename: Takayasu
authors.initials: T
authors.lastname: Ito
authors.affiliation: g Kato Orthopaedic Clinic , Okazaki , Japan.
authors.forename: Takefumi
authors.initials: T
authors.lastname: Kato
authors.affiliation: h Saito Orthopaedic Clinic , Nagoya , Japan.
authors.forename: Kiwamu
authors.initials: K
authors.lastname: Saito
authors.affiliation: a Department of Orthopaedic Surgery and Rheumatology , Nagoya University Graduate School of Medicine , Aichi , Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Funahashi
authors.affiliation: a Department of Orthopaedic Surgery and Rheumatology , Nagoya University Graduate School of Medicine , Aichi , Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Asai
authors.affiliation: a Department of Orthopaedic Surgery and Rheumatology , Nagoya University Graduate School of Medicine , Aichi , Japan.
authors.forename: Toki
authors.initials: T
authors.lastname: Takemoto
authors.affiliation: a Department of Orthopaedic Surgery and Rheumatology , Nagoya University Graduate School of Medicine , Aichi , Japan.
authors.forename: Kenya
authors.initials: K
authors.lastname: Terabe
authors.affiliation: a Department of Orthopaedic Surgery and Rheumatology , Nagoya University Graduate School of Medicine , Aichi , Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Asai
authors.affiliation: a Department of Orthopaedic Surgery and Rheumatology , Nagoya University Graduate School of Medicine , Aichi , Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Ishiguro
authors.affiliation: a Department of Orthopaedic Surgery and Rheumatology , Nagoya University Graduate School of Medicine , Aichi , Japan.
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Kojima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000188:drug therapy*; D001799:Blood Sedimentation; D002867:Chromones / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D011237:Predictive Value of Tests; D012042:Registries; D012074:Remission Induction; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013449:Sulfonamides / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D002867:Chromones; D013449:Sulfonamides; C519076:iguratimod; D008727:Methotrexate
keywords: Adequate observation period; Iguratimod; Japanese; Predictors; Rheumatoid arthritis