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dc.contributor.authorPappas, Dimitrios A.
dc.contributor.authorGerber, Robert A.
dc.contributor.authorLitman, Heather J.
dc.contributor.authorGruben, David
dc.contributor.authorGeier, Jamie
dc.contributor.authorHua, Winnie D.
dc.contributor.authorChen, Connie
dc.contributor.authorLi, YouFu
dc.contributor.authorKremer, Joel M.
dc.contributor.authorAndrews, John S.
dc.contributor.authorBourret, Jeffrey A.
dc.date2022-08-11T08:09:50.000
dc.date.accessioned2022-08-23T16:45:27Z
dc.date.available2022-08-23T16:45:27Z
dc.date.issued2018-05-01
dc.date.submitted2018-07-27
dc.identifier.citation<p>Am Health Drug Benefits. 2018 May;11(3):148-158.</p>
dc.identifier.issn1942-2962 (Linking)
dc.identifier.pmid29910846
dc.identifier.urihttp://hdl.handle.net/20.500.14038/40684
dc.description.abstractBackground: The implementation of treat-to-target principles in rheumatoid arthritis (RA) has not been fully investigated in patients with inadequate response to tumor necrosis factor (TNF) inhibitor treatment. Objectives: To evaluate the prevalence of an inadequate response to initial TNF inhibitor treatment at 6 and 12 months among patients with RA in a real-world patient registry, as well as the delay in therapy adjustment and its impact on disease activity and patient-reported outcome (PRO) measures. Methods: This analysis is based on data of patients with moderate or severe disease activity (Clinical Disease Activity Index [CDAI] score > 10) who were included in the Consortium of Rheumatology Researchers of North America (Corrona) RA registry, a prospective, observational database. The patients had never received treatment with a biologic disease-modifying antirheumatic drug (DMARD) and had initiated treatment with a TNF inhibitor (adalimumab, certolizumab pegol, etanercept, golimumab, or infliximab) between October 2001 and December 2014. We evaluated treatment response (CDAI score < /=10), select PRO measures, and treatment changes at 6 months. Patients who had an inadequate response to TNF inhibitor therapy at 6 months and continued to use their initial TNF inhibitor were evaluated again at 12 months. Results: This retrospective analysis included 2282 patients. At 6 months, 1732 (75.9%) of the patients continued to use their initial TNF inhibitor; of these, 803 (46.4%) patients had an inadequate response to treatment. Of the 803 patients who had an inadequate response at 6 months, 488 (60.8%) continued their initial treatment at 12 months. Of these 488 patients, 315 (64.5%) had an inadequate response at 12 months, and 173 (35.5%) had a response. Numerically greater improvements in all PRO measures were observed for patients who responded to therapy compared with patients with an inadequate response. Conclusions: In this real-world analysis of data from the Corrona RA registry, a considerable proportion of patients with RA had an inadequate response to the initial TNF inhibitor therapy at 6 and 12 months. Many patients continued to have moderate or high disease activity, without accelerating treatment (eg, addition or increase in the dose of concurrent conventional synthetic DMARDs or a TNF inhibitor), contrary to treat-to-target principles, thus remaining at risk for accumulating joint damage and disability.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=29910846&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5973251/
dc.subjectarthritis
dc.subjectCorrona registry
dc.subjectregistries
dc.subjectresponse to therapy
dc.subjectrheumatoid arthritis
dc.subjecttumor necrosis factor inhibitor
dc.subjectMusculoskeletal Diseases
dc.subjectPharmaceutical Preparations
dc.subjectRheumatology
dc.titleDelayed Treatment Acceleration in Patients with Rheumatoid Arthritis Who Have Inadequate Response to Initial Tumor Necrosis Factor Inhibitors: Data from the Corrona Registry
dc.typeJournal Article
dc.source.journaltitleAmerican health and drug benefits
dc.source.volume11
dc.source.issue3
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/oapubs/3486
dc.identifier.contextkey12556165
html.description.abstract<p>Background: The implementation of treat-to-target principles in rheumatoid arthritis (RA) has not been fully investigated in patients with inadequate response to tumor necrosis factor (TNF) inhibitor treatment.</p> <p>Objectives: To evaluate the prevalence of an inadequate response to initial TNF inhibitor treatment at 6 and 12 months among patients with RA in a real-world patient registry, as well as the delay in therapy adjustment and its impact on disease activity and patient-reported outcome (PRO) measures.</p> <p>Methods: This analysis is based on data of patients with moderate or severe disease activity (Clinical Disease Activity Index [CDAI] score > 10) who were included in the Consortium of Rheumatology Researchers of North America (Corrona) RA registry, a prospective, observational database. The patients had never received treatment with a biologic disease-modifying antirheumatic drug (DMARD) and had initiated treatment with a TNF inhibitor (adalimumab, certolizumab pegol, etanercept, golimumab, or infliximab) between October 2001 and December 2014. We evaluated treatment response (CDAI score < /=10), select PRO measures, and treatment changes at 6 months. Patients who had an inadequate response to TNF inhibitor therapy at 6 months and continued to use their initial TNF inhibitor were evaluated again at 12 months.</p> <p>Results: This retrospective analysis included 2282 patients. At 6 months, 1732 (75.9%) of the patients continued to use their initial TNF inhibitor; of these, 803 (46.4%) patients had an inadequate response to treatment. Of the 803 patients who had an inadequate response at 6 months, 488 (60.8%) continued their initial treatment at 12 months. Of these 488 patients, 315 (64.5%) had an inadequate response at 12 months, and 173 (35.5%) had a response. Numerically greater improvements in all PRO measures were observed for patients who responded to therapy compared with patients with an inadequate response.</p> <p>Conclusions: In this real-world analysis of data from the Corrona RA registry, a considerable proportion of patients with RA had an inadequate response to the initial TNF inhibitor therapy at 6 and 12 months. Many patients continued to have moderate or high disease activity, without accelerating treatment (eg, addition or increase in the dose of concurrent conventional synthetic DMARDs or a TNF inhibitor), contrary to treat-to-target principles, thus remaining at risk for accumulating joint damage and disability.</p>
dc.identifier.submissionpathoapubs/3486
dc.contributor.departmentDepartment of Pediatrics
dc.contributor.departmentDepartment of Surgery
dc.source.pages148-158


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