Achieving the goal of rheumatoid arthritis treatment is more common in patients with moderate activity than high disease activity in the real clinical practice of the ATTRA National Registry of Biological Treatment
Abstract
The suitability of biologic therapy in patients with rheumatoid arthritis (RA) of moderate activity is currently being discussed. The aim of the study was to compare the results of treatment of patients with RA of moderate and high activity with the first anti-TNF agent in routine clinical practice.
This was a retrospective cohort study of patients enrolled in the ATTRA national registry. In total, 2416 patients were enrolled in the study, of which 2231 had high activity (DAS 28 > 5.1) and 185 patients had moderate activity (DAS 28 3.2-5.1). Patients were followed for one year, and DAS 28 values were lower in the moderate group than in the high activity group at all intervals evaluated, p < 0.001. Low activity (DAS 28 < 3.2) was achieved by patients with moderate activity in 74% and patients with high activity in 52.2%, p < 0.001. Significant differences in favor of treatment of moderate activity were also found for other secondary endpoints.
Furthermore, a comparison of patients with medium and high activity, selected by the method of propensity score matching, who no longer differ in the input characteristics, was performed. Patients with moderate activity are 2.4 times more likely to achieve remission or low activity according to DAS 28 after six months and 1.7 times more likely to achieve remission or low activity after 12 months of treatment compared to patients with high activity at the beginning of treatment.
This extensive retrospective analysis of the outcome of anti-TNF therapy treatment showed that the therapy of RA patients with moderate is more effective than that of those with high activity because the desired goal is achieved significantly more often, i.e., reaching a state of low activity or remission.