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...
| Authors: | ; ; ; ; ; ; ; ; ; ; |
|---|---|
| Format: | Article |
| Publication date: | 2019 |
| Country: | España |
| Institution: | Universidad Autónoma de Madrid |
| Repository: | Biblos-e Archivo. Repositorio Institucional de la UAM |
| Language: | English |
| OAI Identifier: | oai:repositorio.uam.es:10486/691800 |
| Online Access: | http://hdl.handle.net/10486/691800 https://dx.doi.org/10.1186/s13075-019-1849-3 |
| Access Level: | Open access |
| Keyword: | Axial spondyloarthritis TNF inhibitors Concomitant csDMARDs Body mass index Clinical response Medicina |
| _version_ | 1878740313486393344 |
|---|---|
| author | Hernández-Breijo, Borja |
| 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 |
| author_browse | Balsa Criado, Alejandro Diego, Cristina Gerrit J. Wolbink, Gerrit J. Hernández-Breijo, Borja Jochems, Andrea Kneepkens, Eva L. Martínez-Feito, Ana Navarro-Compán, Victoria Pascual-Salcedo, Dora Plasencia-Rodríguez, Chamaida Rispens, Theo |
| 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 |
| collection | Biblos-e Archivo. Repositorio Institucional de la UAM |
| 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 |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_d0d1f71c951cea930fb15cb58fcefb4e |
| institution | Universidad Autónoma de Madrid |
| instname_str | Universidad Autónoma de Madrid |
| language | eng |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:repositorio.uam.es:10486/691800 |
| publishDate | 2019 |
| publishDateSort | 2019 |
| publisher | BMC |
| publisherStr | BMC |
| reponame_str | Biblos-e Archivo. Repositorio Institucional de la UAM |
| spelling | 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. Gerrit J. Wolbink, Gerrit J. Rispens, Theo Diego, Cristina Pascual-Salcedo, Dora Balsa Criado, Alejandro Axial spondyloarthritis TNF inhibitors Concomitant csDMARDs Body mass index Clinical response Medicina 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 BMC http://hdl.handle.net/10486/691800 https://dx.doi.org/10.1186/s13075-019-1849-3 |
| 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 | 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 | Axial spondyloarthritis TNF inhibitors Concomitant csDMARDs Body mass index Clinical response Medicina |
| topic_facet | Axial spondyloarthritis TNF inhibitors Concomitant csDMARDs Body mass index Clinical response Medicina |
| url | http://hdl.handle.net/10486/691800 https://dx.doi.org/10.1186/s13075-019-1849-3 |