Background Biologic agents are highly effective for rheumatoid arthritis (RA); however, not all cases achieve HAQ remission. Although previous studies have reported the prognostic factors, there is no report on predictive factors for HAQ remission.
Objectives To study predictive factors for HAQ remission, which is one of the treatment goals in RA, after using biologic agents for 6 months.
Methods The subjects were 333 RA patients treated with biologic agents for 6 months. The following patient's characteristics were investigated: age, gender, the number of previous drugs, disease duration, the type of biologic agents, baseline steroid dosage, MTX dosage, serum RF, MMP-3, ACPA, TNF-α, and IL-6. For evaluation we used SDAI for RA disease activity, HAQ for ADL, Short Form (SF)-36 for QOL, and Hamilton Depression Rating Scale (HAM-D) or Self-rating depression scale (SDS) for depression status. HAQ remission was defined by HAQ0.5 after 6 months of treatment. The subjects were divided into two groups: patients with HAQ0.5 and patients with HAQ >0.5 at 6 months, and a retrospective study was conducted. 101 patients were excluded from the study due to loss to 6-month follow-up, and a total of 232 patients were analyzed.
Results Compared with a group of RA patients without HAQ remission (n=68), a group of patients with HAQ remission (n=164) had younger age (54.8±15.2 vs. 61.8±13.3, p=0.0011), lower baseline steroid dosage (3.4±3.7mg vs. 4.5±3.5mg, p=0.037), lower serum MMP-3 (196±234 ng/ml vs. 321±551, p=0.047), lower SDAI (22.5±13.4 vs. 32.1±12.9, p<0.001), lower HAQ (0.39±0.51 vs. 1.08±0.54, p<0.001), higher SF-36 (p<0.05 in all categories), lower SDS (40.4±9.9 vs. 43.5±9.2, p=0.033), and lower HAM-D (5.0±4.3 vs. 8.4±5.0, p<0.001). On the other hand, there was no significant difference on the types of biologic agents, the order of drugs used in the treatment, gender, MTX dosage, disease duration, serum RF, ACPA, TNF-α, and IL-6.
Conclusions It was suggested that RA patients with lower disease activity, lower dosage of steroid, younger age, lower serum MMP-3, higher ADL and QOL, and lower depression scores at baseline are more likely to achieve HAQ remission with biologic treatment.
Disclosure of Interest Y. Miwa Grant/research support from: Astellas Pharm Inc., Mitsubishi Tanabe Pharma Corporation, AbbVie CK, Pfizer Japan Inc., Chugai Pharmaceutical Co., Ltd., and Eizai Co., Ltd., R. Takahashi: None declared, N. Yajima: None declared, K. Wakabayashi: None declared, T. Tokunaga: None declared, S. Ishii: None declared, A. Nishimi: None declared, T. Kasama: None declared, K. Oh: None declared, Y. Toyoshima: None declared, K. Inagaki: None declared