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: | , , , , , , , , , , |
|---|---|
| Formato: | artículo |
| Fecha de publicación: | 2019 |
| País: | España |
| Recursos: | Universidad Autónoma de Madrid |
| Repositorio: | Biblos-e Archivo. Repositorio Institucional de la UAM |
| Idioma: | inglés |
| OAI Identifier: | oai:repositorio.uam.es:10486/691800 |
| Acesso em linha: | http://hdl.handle.net/10486/691800 https://dx.doi.org/10.1186/s13075-019-1849-3 |
| Access Level: | acceso abierto |
| Palavra-chave: | Axial spondyloarthritis TNF inhibitors Concomitant csDMARDs Body mass index Clinical response Medicina |
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Association between concomitant csDMARDs and clinical response to TNF inhibitors in overweight patients with axial spondyloarthritisHernández-Breijo, BorjaPlasencia-Rodríguez, ChamaidaNavarro-Compán, VictoriaMartínez-Feito, AnaJochems, AndreaKneepkens, Eva L.Gerrit J. Wolbink, Gerrit J.Rispens, TheoDiego, CristinaPascual-Salcedo, DoraBalsa Criado, AlejandroAxial spondyloarthritisTNF inhibitorsConcomitant csDMARDsBody mass indexClinical responseMedicinaBackground: 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/m2) and 102 (57%) overweight/obese (≥ 25.0 kg/m2). After the first year of treatment, TNFi trough levels were measured by capture ELISA. Clinical response to TNFi was defined as ΔBASDAI ≥ 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 itBMCDepartamento de MedicinaFacultad de MedicinaInstituto de Investigación Sanitaria del Hospital Universitario de La Paz (IdiPAZ)20192019-02-20research articlehttp://purl.org/coar/resource_type/c_2df8fbb1VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10486/691800https://dx.doi.org/10.1186/s13075-019-1849-3reponame:Biblos-e Archivo. Repositorio Institucional de la UAMinstname:Universidad Autónoma de MadridInglésengopen accesshttp://purl.org/coar/access_right/c_abf2info:eu-repo/semantics/openAccessoai:repositorio.uam.es:10486/6918002026-06-23T12:46:27Z |
| dc.title.none.fl_str_mv |
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 |
| spellingShingle |
Association between concomitant csDMARDs and clinical response to TNF inhibitors in overweight patients with axial spondyloarthritis Hernández-Breijo, Borja Axial spondyloarthritis TNF inhibitors Concomitant csDMARDs Body mass index Clinical response Medicina |
| title_short |
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_sort |
Association between concomitant csDMARDs and clinical response to TNF inhibitors in overweight patients with axial spondyloarthritis |
| dc.creator.none.fl_str_mv |
Hernández-Breijo, Borja Plasencia-Rodríguez, Chamaida Navarro-Compán, Victoria Martínez-Feito, Ana Jochems, Andrea Kneepkens, Eva L. Gerrit J. Wolbink, Gerrit J. Rispens, Theo Diego, Cristina Pascual-Salcedo, Dora Balsa Criado, Alejandro |
| author |
Hernández-Breijo, Borja |
| author_facet |
Hernández-Breijo, Borja Plasencia-Rodríguez, Chamaida Navarro-Compán, Victoria Martínez-Feito, Ana Jochems, Andrea Kneepkens, Eva L. Gerrit J. Wolbink, Gerrit J. Rispens, Theo Diego, Cristina Pascual-Salcedo, Dora Balsa Criado, Alejandro |
| author_role |
author |
| author2 |
Plasencia-Rodríguez, Chamaida Navarro-Compán, Victoria Martínez-Feito, Ana Jochems, Andrea Kneepkens, Eva L. Gerrit J. Wolbink, Gerrit J. Rispens, Theo Diego, Cristina Pascual-Salcedo, Dora Balsa Criado, Alejandro |
| author2_role |
author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
Departamento de Medicina Facultad de Medicina Instituto de Investigación Sanitaria del Hospital Universitario de La Paz (IdiPAZ) |
| dc.subject.none.fl_str_mv |
Axial spondyloarthritis TNF inhibitors Concomitant csDMARDs Body mass index Clinical response Medicina |
| topic |
Axial spondyloarthritis TNF inhibitors Concomitant csDMARDs Body mass index Clinical response Medicina |
| 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/m2) and 102 (57%) overweight/obese (≥ 25.0 kg/m2). After the first year of treatment, TNFi trough levels were measured by capture ELISA. Clinical response to TNFi was defined as ΔBASDAI ≥ 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 |
| publishDate |
2019 |
| dc.date.none.fl_str_mv |
2019 2019-02-20 |
| dc.type.none.fl_str_mv |
research article http://purl.org/coar/resource_type/c_2df8fbb1 VoR http://purl.org/coar/version/c_970fb48d4fbd8a85 |
| dc.type.openaire.fl_str_mv |
info:eu-repo/semantics/article |
| format |
article |
| dc.identifier.none.fl_str_mv |
http://hdl.handle.net/10486/691800 https://dx.doi.org/10.1186/s13075-019-1849-3 |
| url |
http://hdl.handle.net/10486/691800 https://dx.doi.org/10.1186/s13075-019-1849-3 |
| dc.language.none.fl_str_mv |
Inglés eng |
| language_invalid_str_mv |
Inglés |
| language |
eng |
| dc.rights.none.fl_str_mv |
open access http://purl.org/coar/access_right/c_abf2 |
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info:eu-repo/semantics/openAccess |
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open access http://purl.org/coar/access_right/c_abf2 |
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openAccess |
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application/pdf |
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BMC |
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BMC |
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reponame:Biblos-e Archivo. Repositorio Institucional de la UAM instname:Universidad Autónoma de Madrid |
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Universidad Autónoma de Madrid |
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Biblos-e Archivo. Repositorio Institucional de la UAM |
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Biblos-e Archivo. Repositorio Institucional de la UAM |
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