Prediction of remission and low disease activity in disease-modifying anti-rheumatic drug-refractory patients with rheumatoid arthritis treated with golimumab.
To create a tool to predict probability of remission and low disease activity (LDA) in patients with RA being considered for anti-TNF treatment in clinical practice.



We analysed data from GO-MORE, an open-label, multinational, prospective study in biologic-naïve patients with active RA (DAS28-ESR ⩾3.2) despite DMARD therapy. Patients received 50 mg s.c. golimumab (GLM) once monthly for 6 months. In secondary analyses, regression models were used to determine the best set of baseline factors to predict remission (DAS28-ESR <2.6) at month 6 and LDA (DAS28-ESR ⩽3.2) at month 1.



In 3280 efficacy-evaluable patients, of 12 factors included in initial regression models predicting remission or LDA, six were retained in final multivariable models. Greater likelihood of LDA and remission was associated with being male; younger age; lower HAQ, ESR (or CRP) and tender joint count (or swollen joint count) scores; and absence of comorbidities. In models predicting 1-, 3- and 6-month LDA or remission, area under the receiver operating curve was 0.648-0.809 (R(2) = 0.0397-0.1078). The models also predicted 6-month HAQ and EuroQoL-5-dimension scores. A series of matrices were developed to easily show predicted rates of remission and LDA.



A matrix tool was developed to show predicted GLM treatment outcomes in patients with RA, based on a combination of six baseline characteristics. The tool could help provide practical guidance in selection of candidates for anti-TNF therapy.
Department of Medical Affairs, MSD Danmark ApS, Ballerup, Denmark nathan.vastesaeger@merck.com.
Nathan
N
Vastesaeger
Department of Rheumatology, AGAR Francisco Marroquin University, Guatemala City, Guatemala.
Abraham Garcia
AG
Kutzbach
Department of Internal Medicine B and Research Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.
Howard
H
Amital
Institute of Rheumatology and Clinic of Rheumatology, Charles University, Prague, Czech Republic.
Karel
K
Pavelka
Instituto de Asistencia Reumatologica Integral, Buenos Aires, Argentina.
María Alicia
MA
Lazaro
Department of Rheumatology, Clinical Sciences Centre, University Hospital Aintree, Liverpool, UK.
Robert J
RJ
Moots
Department of Rheumatology, Klinik für Rheumatologie, Schön Klinik Hamburg-Eilbek, Hamburg, Germany.
Jürgen
J
Wollenhaupt
Department of Rheumatology, Centro Paulista de Investigação Clinica, São Paulo, Brazil.
Cristiano A F
CA
Zerbini
Panorama Medical Centre, Cape Town, South Africa.
Ingrid
I
Louw
Departement de Rhumatologie, Hôpital Lapeyronie, Montpellier University Hospital, Montpellier, France.
Bernard
B
Combe
Centre de Rhumatologie St-Louis, Québec, Canada.
Andre
A
Beaulieu
Division of Rheumatology and Clinical Immunology, Department of Medicine IV, University of Munich, Munich, Germany.
Hendrik
H
Schulze-Koops
Department of Rheumatology, Southend University Hospital, Westcliff-on-Sea, Essex, UK.
Bhaskar
B
Dasgupta
Department of Biostatistics.
Bo
B
Fu
Department of Biostatistics.
Susan
S
Huyck
Clinical Development, Merck & Co, Inc., Kenilworth, NJ, USA.
Haoling H
HH
Weng
Department of Immunology, MSD Italy, Global Medical Affairs, Rome, Italy.
Marinella
M
Govoni
Department of Rheumatology, Université Catholique de Louvain, Brussels, Belgium.
Patrick
P
Durez
D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012044:Regression Analysis; D012074:Remission Induction; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; C529000:golimumab
biologic; predictors of response; remission; rheumatoid arthritis; tumour necrosis factor