Clinical characteristics of inadequate response to csDMARDs and bDMARDs in patients with rheumatoid arthritis: a cross-sectional, large cohort, real-world practice study.

OBJECTIVE

This study aims to identify clinical characteristics of inadequate response (IR) to conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) and biological disease-modifying antirheumatic drugs (bDMARDs) in patients with rheumatoid arthritis (RA).

METHODS

This study was a retrospective, cross-sectional study based on the registry of Chinese Rheumatism Data Center (CRDC). Patients aged ≥ 18 years old with active RA (DAS28-CRP > 3.2) and at least 1 follow-up visit after baseline were included (to clarify treatment response). A total of 8326 patients in CRDC database were eligible. Within them, 6676 patients were included in analysis of IR to csDMARDs, and 3705(55.50%) of them had IR. A total of 1650 patients were included in analysis of IR to bDMARDs, and 819(49.64%) of them had IR. Data on demographics, disease characteristics, physical and laboratory tests, treatments at entry (i.e. baseline), and follow-up visits were extracted for analysis. Multivariable logistic regression was used to identify predictors of IR to csDMARDs and bDMARDs, respectively.

RESULTS

The final multivariable logistic regression indicated that age, disease duration (Q2,Q3,Q4), DAS28-CRP, Glucocorticoids use, and Leflunomide used were the relevant clinical characteristic of csDMARDs-IR, age, disease duration (Q3,Q4), BMI, DAS28-CRP were the relevant clinical characteristic of bDMARDs-IR.

CONCLUSION

Based on a large registry database, we identified clinical risk factors of IR to treatments, which may help clinicians in therapeutic medication selection in clinical practice.