Patterns of Response to Different Treatment Strategies in Seropositive Rheumatoid Arthritis Patients in a Tertiary Hospital in South‐Western Saudi Arabia: A Retrospective Study

Mohammed AlOmair,* Hanan AlMalki,* Nouf AlShamrani, Ghadah Habtar, Maram AlAsmari, Wejdan Mobasher, Hanan AlQahtani, Aydah Rahman, Alhussain Asiri Division of Rheumatology, Department of Medicine, Aseer Central Hospital, Abha, Saudi Arabia*These authors contributed equally to...

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Autores principales: AlOmair M, AlMalki H, AlShamrani N, Habtar G, AlAsmari M, Mobasher W, AlQahtani H, Rahman A, Asiri A
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Publicado: Dove Medical Press 2021
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spelling oai:doaj.org-article:0ca69d845b5942fd96b6a1f85aefb7a52021-12-02T19:06:29ZPatterns of Response to Different Treatment Strategies in Seropositive Rheumatoid Arthritis Patients in a Tertiary Hospital in South‐Western Saudi Arabia: A Retrospective Study1179-156Xhttps://doaj.org/article/0ca69d845b5942fd96b6a1f85aefb7a52021-08-01T00:00:00Zhttps://www.dovepress.com/patterns-of-response-to-different-treatment-strategies-in-seropositive-peer-reviewed-fulltext-article-OARRRhttps://doaj.org/toc/1179-156XMohammed AlOmair,* Hanan AlMalki,* Nouf AlShamrani, Ghadah Habtar, Maram AlAsmari, Wejdan Mobasher, Hanan AlQahtani, Aydah Rahman, Alhussain Asiri Division of Rheumatology, Department of Medicine, Aseer Central Hospital, Abha, Saudi Arabia*These authors contributed equally to this workCorrespondence: Mohammed AlOmairDivision of Rheumatology, Department of Medicine, Aseer Central Hospital, P.O. Box 34, Abha, Saudi ArabiaTel +966 507735466Fax +966 172243595Email alomair.mohd@gmail.com; MAL-OMAIR@moh.gov.saPurpose: To study the pattern of response to different treatment strategies in seropositive rheumatoid arthritis (RA) patients and to describe our clinical practice in RA management.Patients and Methods: Over a period of two years from April 2018 to April 2020, we conducted a retrospective analysis of data for 288 consecutive seropositive RA patients attending rheumatology clinics and the daycare unit at Aseer Central Hospital. Data were collected on patient demographics, disease duration, extraarticular manifestations, comorbidities and treatment. Disease activity was assessed using the clinical disease activity index (CDAI).Results: Out of the total 288 patients, 42% (120) are on csDMRADs, while 54% (162) are on bDMRADs and 4% (6) are on tsDMARDs. Of the patients on csDMARDS, 51%, 43% and 7% of them were on remission, low and moderate disease activity, respectively. However, of the patients on non-csDMARDS, 36.3%, 49.4% and 14.3% of them were on remission, low and moderate disease activity, respectively. Failure of csDMARDs was affected by the presence of high disease activity at baseline, extraarticular lung manifestations and coexistent fibromyalgia, with a significant effect of the latter on remission rate. Among patients on non-csDMARDs, 42 (25%) showed one or more therapy changes. Tumor necrosis factor inhibitors were the predominant first-line agents in biologically naive patients (65%) followed by abatacept (18%). Abatacept was the most frequently prescribed second biologic in 52% of cases followed by tocilizumab in 19%.Conclusion: The current clinical practice in our hospital is consistent with the latest American College of Rheumatology (ACR)/The European League Against Rheumatism (EULAR) guidelines. Treat-to-target strategy was achieved in the vast majority of our patients, while remission was observed in almost half of the patients.Keywords: rheumatoid arthritis, DMARDs, biologics, remission, CDAIAlOmair MAlMalki HAlShamrani NHabtar GAlAsmari MMobasher WAlQahtani HRahman AAsiri ADove Medical Pressarticlerheumatoid arthritisdmardsbiologicsremissioncdaiDiseases of the musculoskeletal systemRC925-935ENOpen Access Rheumatology: Research and Reviews, Vol Volume 13, Pp 239-246 (2021)
institution DOAJ
collection DOAJ
language EN
topic rheumatoid arthritis
dmards
biologics
remission
cdai
Diseases of the musculoskeletal system
RC925-935
spellingShingle rheumatoid arthritis
dmards
biologics
remission
cdai
Diseases of the musculoskeletal system
RC925-935
AlOmair M
AlMalki H
AlShamrani N
Habtar G
AlAsmari M
Mobasher W
AlQahtani H
Rahman A
Asiri A
Patterns of Response to Different Treatment Strategies in Seropositive Rheumatoid Arthritis Patients in a Tertiary Hospital in South‐Western Saudi Arabia: A Retrospective Study
description Mohammed AlOmair,* Hanan AlMalki,* Nouf AlShamrani, Ghadah Habtar, Maram AlAsmari, Wejdan Mobasher, Hanan AlQahtani, Aydah Rahman, Alhussain Asiri Division of Rheumatology, Department of Medicine, Aseer Central Hospital, Abha, Saudi Arabia*These authors contributed equally to this workCorrespondence: Mohammed AlOmairDivision of Rheumatology, Department of Medicine, Aseer Central Hospital, P.O. Box 34, Abha, Saudi ArabiaTel +966 507735466Fax +966 172243595Email alomair.mohd@gmail.com; MAL-OMAIR@moh.gov.saPurpose: To study the pattern of response to different treatment strategies in seropositive rheumatoid arthritis (RA) patients and to describe our clinical practice in RA management.Patients and Methods: Over a period of two years from April 2018 to April 2020, we conducted a retrospective analysis of data for 288 consecutive seropositive RA patients attending rheumatology clinics and the daycare unit at Aseer Central Hospital. Data were collected on patient demographics, disease duration, extraarticular manifestations, comorbidities and treatment. Disease activity was assessed using the clinical disease activity index (CDAI).Results: Out of the total 288 patients, 42% (120) are on csDMRADs, while 54% (162) are on bDMRADs and 4% (6) are on tsDMARDs. Of the patients on csDMARDS, 51%, 43% and 7% of them were on remission, low and moderate disease activity, respectively. However, of the patients on non-csDMARDS, 36.3%, 49.4% and 14.3% of them were on remission, low and moderate disease activity, respectively. Failure of csDMARDs was affected by the presence of high disease activity at baseline, extraarticular lung manifestations and coexistent fibromyalgia, with a significant effect of the latter on remission rate. Among patients on non-csDMARDs, 42 (25%) showed one or more therapy changes. Tumor necrosis factor inhibitors were the predominant first-line agents in biologically naive patients (65%) followed by abatacept (18%). Abatacept was the most frequently prescribed second biologic in 52% of cases followed by tocilizumab in 19%.Conclusion: The current clinical practice in our hospital is consistent with the latest American College of Rheumatology (ACR)/The European League Against Rheumatism (EULAR) guidelines. Treat-to-target strategy was achieved in the vast majority of our patients, while remission was observed in almost half of the patients.Keywords: rheumatoid arthritis, DMARDs, biologics, remission, CDAI
format article
author AlOmair M
AlMalki H
AlShamrani N
Habtar G
AlAsmari M
Mobasher W
AlQahtani H
Rahman A
Asiri A
author_facet AlOmair M
AlMalki H
AlShamrani N
Habtar G
AlAsmari M
Mobasher W
AlQahtani H
Rahman A
Asiri A
author_sort AlOmair M
title Patterns of Response to Different Treatment Strategies in Seropositive Rheumatoid Arthritis Patients in a Tertiary Hospital in South‐Western Saudi Arabia: A Retrospective Study
title_short Patterns of Response to Different Treatment Strategies in Seropositive Rheumatoid Arthritis Patients in a Tertiary Hospital in South‐Western Saudi Arabia: A Retrospective Study
title_full Patterns of Response to Different Treatment Strategies in Seropositive Rheumatoid Arthritis Patients in a Tertiary Hospital in South‐Western Saudi Arabia: A Retrospective Study
title_fullStr Patterns of Response to Different Treatment Strategies in Seropositive Rheumatoid Arthritis Patients in a Tertiary Hospital in South‐Western Saudi Arabia: A Retrospective Study
title_full_unstemmed Patterns of Response to Different Treatment Strategies in Seropositive Rheumatoid Arthritis Patients in a Tertiary Hospital in South‐Western Saudi Arabia: A Retrospective Study
title_sort patterns of response to different treatment strategies in seropositive rheumatoid arthritis patients in a tertiary hospital in south‐western saudi arabia: a retrospective study
publisher Dove Medical Press
publishDate 2021
url https://doaj.org/article/0ca69d845b5942fd96b6a1f85aefb7a5
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