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Association between concomitant csDMARDs and clinical response to TNF inhibitors in overweight patients with axial spondyloarthritis
BACKGROUND: The aim of our study was to investigate the influence of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) and body mass index (BMI) on circulating drug levels and clinical response to tumour necrosis factor inhibitor (TNFi) therapy in axial spondyloarthritis (axSp...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6383284/ https://www.ncbi.nlm.nih.gov/pubmed/30786913 http://dx.doi.org/10.1186/s13075-019-1849-3 |
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author | Hernández-Breijo, Borja Plasencia-Rodríguez, Chamaida Navarro-Compán, Victoria Martínez-Feito, Ana Jochems, Andrea Kneepkens, Eva L. Wolbink, Gerrit J. Rispens, Theo Diego, Cristina Pascual-Salcedo, Dora Balsa, Alejandro |
author_facet | Hernández-Breijo, Borja Plasencia-Rodríguez, Chamaida Navarro-Compán, Victoria Martínez-Feito, Ana Jochems, Andrea Kneepkens, Eva L. Wolbink, Gerrit J. Rispens, Theo Diego, Cristina Pascual-Salcedo, Dora Balsa, Alejandro |
author_sort | Hernández-Breijo, Borja |
collection | PubMed |
description | BACKGROUND: The aim of our study was to investigate the influence of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) and body mass index (BMI) on circulating drug levels and clinical response to tumour necrosis factor inhibitor (TNFi) therapy in axial spondyloarthritis (axSpA) patients. METHODS: Prospective observational study during 1 year with 2 cohorts (Madrid and Amsterdam) including 180 axSpA patients treated with standard doses of infliximab or adalimumab. Patients were stratified by BMI, being 78 (43%) normal weight (18.5–24.9 kg/m(2)) and 102 (57%) overweight/obese (≥ 25.0 kg/m(2)). After the first year of treatment, TNFi trough levels were measured by capture ELISA. Clinical response to TNFi was defined as ∆BASDAI ≥ 2 and clinical remission as BASDAI < 2 and CRP ≤ 5 mg/L. Logistic regression models were employed to analyse the association between concomitant csDMARDs and BMI with drug levels and clinical response. RESULTS: Seventy-nine patients (44%) received concomitant csDMARDs. The administration of concomitant csDMARDs (OR 3.82; 95% CI 1.06–13.84) and being normal weight (OR 18.38; 95% CI 2.24–150.63) were independently associated with serum TNFi drug persistence. Additionally, the use of concomitant csDMARDs contributed positively to achieve clinical response (OR 7.86; 95% CI 2.39–25.78) and remission (OR 4.84; 95% CI 1.09–21.36) in overweight/obese patients, but no association was found for normal-weight patients (OR 1.10; 0.33–3.58). CONCLUSIONS: The use of concomitant csDMARDs with TNFi may increase the probability of achieving clinical response in overweight/obese axSpA patients. Further research studies including larger cohorts of patients need to be done to confirm it. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13075-019-1849-3) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6383284 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-63832842019-03-01 Association between concomitant csDMARDs and clinical response to TNF inhibitors in overweight patients with axial spondyloarthritis Hernández-Breijo, Borja Plasencia-Rodríguez, Chamaida Navarro-Compán, Victoria Martínez-Feito, Ana Jochems, Andrea Kneepkens, Eva L. Wolbink, Gerrit J. Rispens, Theo Diego, Cristina Pascual-Salcedo, Dora Balsa, Alejandro Arthritis Res Ther Research Article BACKGROUND: The aim of our study was to investigate the influence of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) and body mass index (BMI) on circulating drug levels and clinical response to tumour necrosis factor inhibitor (TNFi) therapy in axial spondyloarthritis (axSpA) patients. METHODS: Prospective observational study during 1 year with 2 cohorts (Madrid and Amsterdam) including 180 axSpA patients treated with standard doses of infliximab or adalimumab. Patients were stratified by BMI, being 78 (43%) normal weight (18.5–24.9 kg/m(2)) and 102 (57%) overweight/obese (≥ 25.0 kg/m(2)). After the first year of treatment, TNFi trough levels were measured by capture ELISA. Clinical response to TNFi was defined as ∆BASDAI ≥ 2 and clinical remission as BASDAI < 2 and CRP ≤ 5 mg/L. Logistic regression models were employed to analyse the association between concomitant csDMARDs and BMI with drug levels and clinical response. RESULTS: Seventy-nine patients (44%) received concomitant csDMARDs. The administration of concomitant csDMARDs (OR 3.82; 95% CI 1.06–13.84) and being normal weight (OR 18.38; 95% CI 2.24–150.63) were independently associated with serum TNFi drug persistence. Additionally, the use of concomitant csDMARDs contributed positively to achieve clinical response (OR 7.86; 95% CI 2.39–25.78) and remission (OR 4.84; 95% CI 1.09–21.36) in overweight/obese patients, but no association was found for normal-weight patients (OR 1.10; 0.33–3.58). CONCLUSIONS: The use of concomitant csDMARDs with TNFi may increase the probability of achieving clinical response in overweight/obese axSpA patients. Further research studies including larger cohorts of patients need to be done to confirm it. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13075-019-1849-3) contains supplementary material, which is available to authorized users. BioMed Central 2019-02-20 2019 /pmc/articles/PMC6383284/ /pubmed/30786913 http://dx.doi.org/10.1186/s13075-019-1849-3 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Hernández-Breijo, Borja Plasencia-Rodríguez, Chamaida Navarro-Compán, Victoria Martínez-Feito, Ana Jochems, Andrea Kneepkens, Eva L. Wolbink, Gerrit J. Rispens, Theo Diego, Cristina Pascual-Salcedo, Dora Balsa, Alejandro Association between concomitant csDMARDs and clinical response to TNF inhibitors in overweight patients with axial spondyloarthritis |
title | Association between concomitant csDMARDs and clinical response to TNF inhibitors in overweight patients with axial spondyloarthritis |
title_full | Association between concomitant csDMARDs and clinical response to TNF inhibitors in overweight patients with axial spondyloarthritis |
title_fullStr | Association between concomitant csDMARDs and clinical response to TNF inhibitors in overweight patients with axial spondyloarthritis |
title_full_unstemmed | Association between concomitant csDMARDs and clinical response to TNF inhibitors in overweight patients with axial spondyloarthritis |
title_short | Association between concomitant csDMARDs and clinical response to TNF inhibitors in overweight patients with axial spondyloarthritis |
title_sort | association between concomitant csdmards and clinical response to tnf inhibitors in overweight patients with axial spondyloarthritis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6383284/ https://www.ncbi.nlm.nih.gov/pubmed/30786913 http://dx.doi.org/10.1186/s13075-019-1849-3 |
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