TocilizumabV1, Main, Exploration, bibRecord, 000333

Individual therapeutic DAS28-dcrit responses differentiate between effectiveness of rheumatoid arthritis therapies and reflect patient-reported outcomes: retrospective analysis of DAS28 responses in comparative tocilizumab studies.

Identifieur interne : 000333 ( Main/Exploration ); précédent : 000332; suivant : 000334

Individual therapeutic DAS28-dcrit responses differentiate between effectiveness of rheumatoid arthritis therapies and reflect patient-reported outcomes: retrospective analysis of DAS28 responses in comparative tocilizumab studies.

Auteurs : Michaela Koehm [Allemagne] ; Matthew J. Mcintosh [États-Unis] ; Michael W. Hofmann [Allemagne] ; Varghese Abraham [États-Unis] ; Cem Gabay [Suisse] ; Ernest H. Choy [Royaume-Uni] ; Arthur Kavanaugh [États-Unis] ; Harald Burkhardt [Allemagne] ; Frank Behrens [Allemagne]

Source :

Rheumatology international [ 1437-160X ] ; 2020.

RBID : pubmed:32040761

Abstract

Assessment of individual therapeutic responses provides valuable information concerning treatment benefits in individual patients. We evaluated individual therapeutic responses as determined by the Disease Activity Score-28 joints critical difference for improvement (DAS28-d_crit) in rheumatoid arthritis (RA) patients treated with intravenous tocilizumab or comparator anti-tumor necrosis factor (TNF) agents. The previously published DAS28-d_crit value [DAS28 decrease (improvement) ≥ 1.8] was retrospectively applied to data from two studies of tocilizumab in RA, the 52-week ACT-iON observational study and the 24-week ADACTA randomized study. Data were compared within (not between) studies. DAS28 was calculated with erythrocyte sedimentation rate as the inflammatory marker. Stability of DAS28-d_crit responses and European League Against Rheumatism (EULAR) good responses was determined by evaluating repeated responses at subsequent timepoints. A logistic regression model was used to calculate p values for differences in response rates between active agents. Patient-reported outcomes (PROs; pain, global health, function, and fatigue) in DAS28-d_crit responder versus non-responder groups were compared with an ANCOVA model. DAS28-d_crit individual response rates were 78.2% in tocilizumab-treated patients and 58.2% in anti-TNF-treated patients at week 52 in the ACT-ion study (p = 0.0001) and 90.1% versus 59.1% at week 24 in the ADACTA study (p < 0.0001). DAS28-d_crit responses showed greater stability over time (up to 52 weeks) than EULAR good responses. For both active treatments, DAS28-d_crit responses were associated with statistically significant improvements in mean PRO values compared with non-responders. The DAS28-d_crit response criterion provides robust assessments of individual responses to RA therapy and may be useful for discriminating between active agents in clinical studies and guiding treat-to-target decisions in daily practice.

DOI: 10.1007/s00296-020-04514-7
PubMed: 32040761

Affiliations:

Le document en format XML

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<front><div type="abstract" xml:lang="en">Assessment of individual therapeutic responses provides valuable information concerning treatment benefits in individual patients. We evaluated individual therapeutic responses as determined by the Disease Activity Score-28 joints critical difference for improvement (DAS28-d<sub>crit</sub>
) in rheumatoid arthritis (RA) patients treated with intravenous tocilizumab or comparator anti-tumor necrosis factor (TNF) agents. The previously published DAS28-d<sub>crit</sub>
 value [DAS28 decrease (improvement) ≥ 1.8] was retrospectively applied to data from two studies of tocilizumab in RA, the 52-week ACT-iON observational study and the 24-week ADACTA randomized study. Data were compared within (not between) studies. DAS28 was calculated with erythrocyte sedimentation rate as the inflammatory marker. Stability of DAS28-d<sub>crit</sub>
 responses and European League Against Rheumatism (EULAR) good responses was determined by evaluating repeated responses at subsequent timepoints. A logistic regression model was used to calculate p values for differences in response rates between active agents. Patient-reported outcomes (PROs; pain, global health, function, and fatigue) in DAS28-d<sub>crit</sub>
 responder versus non-responder groups were compared with an ANCOVA model. DAS28-d<sub>crit</sub>
 individual response rates were 78.2% in tocilizumab-treated patients and 58.2% in anti-TNF-treated patients at week 52 in the ACT-ion study (p = 0.0001) and 90.1% versus 59.1% at week 24 in the ADACTA study (p < 0.0001). DAS28-d<sub>crit</sub>
 responses showed greater stability over time (up to 52 weeks) than EULAR good responses. For both active treatments, DAS28-d<sub>crit</sub>
 responses were associated with statistically significant improvements in mean PRO values compared with non-responders. The DAS28-d<sub>crit</sub>
 response criterion provides robust assessments of individual responses to RA therapy and may be useful for discriminating between active agents in clinical studies and guiding treat-to-target decisions in daily practice.</div>
</front>
</TEI>
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<country name="Royaume-Uni"><noRegion><name sortKey="Choy, Ernest H" sort="Choy, Ernest H" uniqKey="Choy E" first="Ernest H" last="Choy">Ernest H. Choy</name>
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Individual therapeutic DAS28-dcrit responses differentiate between effectiveness of rheumatoid arthritis therapies and reflect patient-reported outcomes: retrospective analysis of DAS28 responses in comparative tocilizumab studies.

Individual therapeutic DAS28-dcrit responses differentiate between effectiveness of rheumatoid arthritis therapies and reflect patient-reported outcomes: retrospective analysis of DAS28 responses in comparative tocilizumab studies.

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