Predictive factors for effective selection of Interleukin-6 inhibitor and tumor necrosis factor inhibitor in the treatment of rheumatoid arthritis View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2020-10-06

AUTHORS

Shinya Hayashi, Tsukasa Matsubara, Koji Fukuda, Keiko Funahashi, Marowa Hashimoto, Toshihisa Maeda, Tomoyuki Kamenaga, Yoshinori Takashima, Tomoyuki Matsumoto, Takahiro Niikura, Ryosuke Kuroda

ABSTRACT

Treatment of rheumatoid arthritis (RA) is aimed at long-term remission and inhibition of joint destruction by different biologic drugs. However, the choice of a particular biologic agent based on individual cases of RA remains unestablished. Interleukin-6 (IL-6) inhibitor and tumor necrosis factor (TNF) inhibitor are common biologics used for the treatment of RA. This study aimed to investigate predictive factors for effective selection of tocilizumab (IL-6 inhibitor) and etanercept (TNF inhibitor) in patients with RA. This is a retrospective cohort study. The 196 patients analyzed in this study were divided into four groups: tocilizumab treatment as the first biologic group (TCZ first, 42 patients), tocilizumab as second/ third biologic group (TCZ second, 34 patients), etanercept as the first biologic group (ETN first, 103 patients) and etanercept as second/third group (ETN second, 17 patients). Visual analog scale (VAS), clinical disease activity index (CDAI), and modified health assessment questionnaire (mHAQ) scores at the initiation of biologic treatment and after 6 months of tocilizumab and etanercept therapy were measured and compared to clinical parameters and radiographical parameters among the four groups. CRP, MMP-3, VAS, CDAI, and HAQ were improved after 6 months of treatment in all groups. Improvement of clinical outcomes was correlated with CRP value, duration of RA, and Sharp scores at the initiation of treatment. Multivariate analysis demonstrated improvement in CDAI was significantly associated with the yearly progression of erosion according to the Sharp score in TCZ first group (OR, 1.5; 95% CI, 1.03–2.07) and was negatively associated with the duration of RA (OR, 0.49; 95% CI, 0.29–0.86) at the initiation of treatment with ETN first group. We identified the predictive factors for effective selection of tocilizumab and etanercept treatment and established the effectiveness of tocilizumab for the patients with rapid progressive joint erosion and etanercept for the early administration from diagnosis of RA. More... »

PAGES

16645

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/s41598-020-73968-3

DOI

http://dx.doi.org/10.1038/s41598-020-73968-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1131441034

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/33024253


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29 schema:description Treatment of rheumatoid arthritis (RA) is aimed at long-term remission and inhibition of joint destruction by different biologic drugs. However, the choice of a particular biologic agent based on individual cases of RA remains unestablished. Interleukin-6 (IL-6) inhibitor and tumor necrosis factor (TNF) inhibitor are common biologics used for the treatment of RA. This study aimed to investigate predictive factors for effective selection of tocilizumab (IL-6 inhibitor) and etanercept (TNF inhibitor) in patients with RA. This is a retrospective cohort study. The 196 patients analyzed in this study were divided into four groups: tocilizumab treatment as the first biologic group (TCZ first, 42 patients), tocilizumab as second/ third biologic group (TCZ second, 34 patients), etanercept as the first biologic group (ETN first, 103 patients) and etanercept as second/third group (ETN second, 17 patients). Visual analog scale (VAS), clinical disease activity index (CDAI), and modified health assessment questionnaire (mHAQ) scores at the initiation of biologic treatment and after 6 months of tocilizumab and etanercept therapy were measured and compared to clinical parameters and radiographical parameters among the four groups. CRP, MMP-3, VAS, CDAI, and HAQ were improved after 6 months of treatment in all groups. Improvement of clinical outcomes was correlated with CRP value, duration of RA, and Sharp scores at the initiation of treatment. Multivariate analysis demonstrated improvement in CDAI was significantly associated with the yearly progression of erosion according to the Sharp score in TCZ first group (OR, 1.5; 95% CI, 1.03–2.07) and was negatively associated with the duration of RA (OR, 0.49; 95% CI, 0.29–0.86) at the initiation of treatment with ETN first group. We identified the predictive factors for effective selection of tocilizumab and etanercept treatment and established the effectiveness of tocilizumab for the patients with rapid progressive joint erosion and etanercept for the early administration from diagnosis of RA.
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37 Clinical Disease Activity Index
38 HAQ
39 Health Assessment Questionnaire score
40 MMP-3
41 Sharp score
42 activity index
43 administration
44 agents
45 analog scale
46 analysis
47 arthritis
48 biologic agents
49 biologic drugs
50 biologic group
51 biologic treatment
52 biologics
53 cases
54 choice
55 clinical outcomes
56 clinical parameters
57 cohort study
58 common biologic
59 destruction
60 diagnosis
61 diagnosis of RA
62 different biologic drugs
63 disease activity index
64 drugs
65 duration
66 duration of RA
67 early administration
68 effective selection
69 effectiveness
70 effectiveness of tocilizumab
71 erosion
72 etanercept
73 etanercept therapy
74 etanercept treatment
75 factor inhibitors
76 factors
77 first group
78 group
79 improvement
80 index
81 individual cases
82 inhibition
83 inhibitors
84 initiation
85 initiation of treatment
86 interleukin-6 inhibitors
87 joint destruction
88 joint erosions
89 long-term remission
90 months
91 months of treatment
92 multivariate analysis
93 necrosis factor inhibitors
94 outcomes
95 parameters
96 patients
97 predictive factors
98 progression
99 questionnaire scores
100 radiographical parameters
101 remission
102 retrospective cohort study
103 rheumatoid arthritis
104 scale
105 scores
106 selection
107 study
108 therapy
109 third group
110 tocilizumab
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112 treatment
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114 tumor necrosis factor inhibitors
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