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Erschienen in: Rheumatology International 10/2017

09.06.2017 | Observational Research

Optimization of biological therapy in rheumatoid arthritis patients: outcomes from the CREATE registry after 2 years of follow-up

verfasst von: Manuel J. Cárdenas, Soraya de la Fuente, María C. Castro-Villegas, Montserrat Romero-Gómez, Desiré Ruiz-Vílchez, Jerusalem Calvo-Gutiérrez, Alejandro Escudero-Contreras, José R. del Prado, Eduardo Collantes-Estévez, Pilar Font

Erschienen in: Rheumatology International | Ausgabe 10/2017

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Abstract

The current strategy for managing rheumatoid arthritis (RA) focuses on achieving clinical remission. Once remission is achieved and sustained over time, the most efficient strategy is dose optimization. This work describes the results of dose optimization after 2 years of follow-up in patients with RA treated with biological therapy and identifies predictive variables of response. Cohort: patients from the CREATE registry who, as of 1 November 2013, had been in clinical remission (DAS28 ≤2.6) for at least 6 months. Intervention: Dose optimization was 20–50% of the standard dose. Outcome measurement were effectiveness (percentage of patients who continued to meet criteria for clinical remission) and efficiency (dose reduction and mean savings). Sixty-eight patients with RA were optimized, with initial mean DAS28 of 2.2 ± 0.7. After 2 years of follow-up, the mean DAS28 was 2.4 ± 0.7, a non-statistically significant difference. Twenty-eight patients (41.2%) continued in clinical remission with dose optimization after 2 years. Mean survival time was 14.2 months (95% CI 12.0–16.5). Of the 40 patients who needed to return to a standard dose, 57.5% managed to achieve remission again at 2 years. Mean dose reduction at 2 years was 21.17%, reaching a mean saving of €5576 ± 5099 per patient. In actual clinical practice, over 40% of patients with established RA who had been in sustained clinical remission managed to continue in remission 2 years after receiving optimized doses. The savings achieved was about 21% of the actual direct health costs for patients in the CREATE registry.
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Metadaten
Titel
Optimization of biological therapy in rheumatoid arthritis patients: outcomes from the CREATE registry after 2 years of follow-up
verfasst von
Manuel J. Cárdenas
Soraya de la Fuente
María C. Castro-Villegas
Montserrat Romero-Gómez
Desiré Ruiz-Vílchez
Jerusalem Calvo-Gutiérrez
Alejandro Escudero-Contreras
José R. del Prado
Eduardo Collantes-Estévez
Pilar Font
Publikationsdatum
09.06.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Rheumatology International / Ausgabe 10/2017
Print ISSN: 0172-8172
Elektronische ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-017-3757-7

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