Association between concomitant csDMARDs and clinical response to TNF inhibitors in overweight patients with axial spondyloarthritis
Entity
UAM. Departamento de Medicina; Instituto de Investigación Sanitaria Hospital Universitario de La Paz (IdiPAZ)Publisher
BMCDate
2019-02-20Citation
10.1186/s13075-019-1849-3
Arthritis Research & Therapy 21 (2019): 66
ISSN
1478-6354 (print); 1478-6362 (online)DOI
10.1186/s13075-019-1849-3Editor's Version
https://doi.org/10.1186/s13075-019-1849-3Subjects
Axial spondyloarthritis; TNF inhibitors; Concomitant csDMARDs; Body mass index; Clinical response; MedicinaRights
© 2019 Los autoresAbstract
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
Files in this item
Google Scholar:Hernández-Breijo, Borja
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Plasencia-Rodríguez, Chamaida
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Navarro-Compán, Victoria
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Martínez-Feito, Ana
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Jochems, Andrea
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Kneepkens, Eva L.
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Gerrit J. Wolbink, Gerrit J.
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Rispens, Theo
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Diego, Cristina
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Pascual-Salcedo, Dora
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Balsa Criado, Alejandro
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