Health assessment, CRP found predictive of tapering in patients with RA in remission with TNFi

MADRID — Health assessment questionnaire score and C-reactive protein level predicted successful tapering of medication in patients with rheumatoid arthritis who were in remission with tumor necrosis factor inhibitors, according to a recently analysis presented at EULAR Annual Congress.

“We have developed a composite index that was able to predict a successful [tumor necrosis factor inhibitor] TNFi spacing,” Thao Pham, MD, said in her presentation.

Researchers investigated TNFi spacing in 137 patients with rheumatoid arthritis who were randomly assigned into two groups. The first group continued to receive TNFi at the standard regimen. The second group received a progressive spacing of subcutaneous adalimumab or etanercept until discontinuation. Successful tapering was defined as reaching at least 25% tapering of the full regimen during at least 6 months

Investigators found all baseline variables were similar between failure or success of TNFi spacing, with the exception of health assessment questionnaire (HAQ) score (0.3 for success vs. 0.89 for failure) and C-reactive protein (CRP; 2.35 mg/L for success vs. 3.48 mg/L for failure). Investigators found HAQ — at a threshold of at least 1.125 — had a specificity of 93% and CRP — at a threshold of at least 6.8 mg/L — had a specificity of 0.97. Researchers developed a composite criteria score based off anti-citrullinated protein antibody (ACPA) status, Boolean criteria, simplified disease activity index, CRP and HAQ, for which a score lower than 0.502 could predict successful TNFi spacing with a specificity of 100% and a sensitivity of 54%. – by Will A. Offit

Reference:

Barral T, et al. Abstract #OP0018. Presented at: EULAR Annual Congress; June 14-17, 2017; Madrid.

Disclosure: The researchers report no relevant financial disclosures.