Prediction of DAS28-ESR remission at 6 months by baseline variables in patients with rheumatoid arthritis treated with etanercept in Japanese population

被引：25

作者：

Iwamoto, Naoki ^{[1
]}

Kawakami, Atsushi ^{[1
]}

Fujikawa, Keita ^{[1
]}

Aramaki, Toshiyuki ^{[1
]}

Kawashiri, Shin-ya ^{[1
]}

Tamai, Mami ^{[1
]}

Arima, Kazuhiko ^{[1
]}

Ichinose, Kunihiro ^{[1
]}

Kamachi, Makoto ^{[1
]}

Yamasaki, Satoshi ^{[1
]}

Nakamura, Hideki ^{[1
]}

Nakashima, Munetoshi ^{[2
]}

Mizokami, Akinari ^{[3
]}

Goto, Akiko ^{[4
]}

Fukuda, Takaaki ^{[4
]}

Matsuoka, Naoki ^{[5
]}

Ueki, Yukitaka ^{[6
]}

Tsukada, Toshiaki ^{[7
]}

Migita, Kiyoshi ^{[8
]}

Shoumura, Fumiko ^{[9
]}

Kawabe, Yojiro ^{[9
]}

Shibatomi, Kazutaka ^{[10
]}

Mine, Masanobu ^{[11
]}

Ida, Hiroaki ^{[1
]}

Origuchi, Tomoki ^{[12
]}

Aoyagi, Kiyoshi ^{[13
]}

Eguchi, Katsumi ^{[1
]}

机构：

[1] Nagasaki Univ, Grad Sch Biomed Sci, Dept Immunol & Rheumatol, Unit Translat Med, Nagasaki 8528501, Japan

[2] Japanese Red Cross Nagasaki Atom Bomb Hosp, Nagasaki, Japan

[3] Nagasaki Citizen Hosp, Nagasaki, Japan

[4] Kurume Univ, Sch Med, Kurume, Fukuoka 830, Japan

[5] Nagasaki Med Hosp Rheumatol, Nagasaki, Japan

[6] Sasebo Chuo Hosp, Sasebo, Japan

[7] Isahaya Gen Hosp, Nagasaki, Japan

[8] NHO Nagasaki Med Ctr, Nagasaki, Japan

[9] NHO Ureshino Med Ctr, Saga, Japan

[10] Oita Prefectural Hosp, Oita, Japan

[11] Suga Orthoped Hosp, Nagasaki, Japan

[12] Nagasaki Univ, Sch Hlth Sci, Nagasaki 8528520, Japan

[13] Nagasaki Univ, Grad Sch Biomed Sci, Dept Publ Hlth, Nagasaki 8528501, Japan

来源：

MODERN RHEUMATOLOGY | 2009年 / 19卷 / 05期

关键词：

Etanercept; Rheumatoid arthritis; MTX; Non-MTX nonbiologic DMARDs; DAS28-ESR; METHOTREXATE; THERAPY; INFLIXIMAB; REGISTER; TRIAL;

D O I：

10.1007/s10165-009-0187-8

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

We tried to determine which baseline variables are responsible for remission induction at 6 months in unselected rheumatoid arthritis (RA) patients of Japanese population treated with etanercept. One hundred forty-one patients with RA who were administered etanercept were registered. Thirty-four patients were started on etanercept monotherapy, 60 patients on cotherapy with methotrexate (MTX) (MTX cotherapy), and 47 patients on cotherapy with other non-MTX nonbiologic disease-modifying antirheumatic drugs (DMARDs) (non-MTX cotherapy). None of the patients were treated with both MTX and non-MTX nonbiologic DMARDs at entry. Outcome was set as achievement of disease activity score 28 (DAS28)-ESR remission at 6 months. We examined association of gender, DAS at baseline, MTX cotherapy at baseline, non-MTX cotherapy at baseline, and prednisolone use at baseline with achievement of remission at 6 months by logistic regression analysis. All subjects were classified as having high (N = 109) or moderate disease activity (N = 32) at entry. One hundred twenty out of 141 patients (85.1%) continued treatment with etanercept at 6 months. Continuation rate was statistically higher in MTX cotherapy (93.3%) compared with etanercept monotherapy (73.5%), and tended to be higher than with non-MTX cotherapy (85.1%). Logistic regression analysis identified that MTX cotherapy at entry and moderate disease activity at entry were independent variables for remission induction at 6 months. Accordingly, DAS28-ESR at 6 months was significantly lower with MTX cotherapy as compared with etanercept monotherapy or non-MTX cotherapy. To a lesser extent, DAS28-ESR with non-MTX cotherapy at 6 months was lower than with etanercept monotherapy. In this study of unselected patients, use ofMTXandmoderate disease activity at entry were associated with higher likelihood of response to etanercept. Non-MTX nonbiologic DMARDs may be an alternative in RA patients administrated etanercept who are intolerant to MTX.

引用

页码：488 / 492

页数：5

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