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Factors Associated With Sustained Remission in Rheumatoid Arthritis in Patients Treated With Anti-Tumor Necrosis

Philip Hamann1, Richard Holland2, Kimme Hyrich3

  • 1University of Bath, Claverton Down, and Royal United Hospitals, Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath, UK.

Arthritis Care & Research
|August 27, 2016
PubMed
Abstract

Insights

Predicting sustained remission in rheumatoid arthritis (RA) is challenging. Concomitant methotrexate use improves outcomes, while higher disease activity and certain patient factors reduce the likelihood of sustained remission with anti-tumor necrosis factor (anti-TNF) therapy.

Area of Science:

  • Rheumatology
  • Immunology
  • Clinical Medicine

Background:

  • Anti-tumor necrosis factor (anti-TNF) therapy has transformed rheumatoid arthritis (RA) treatment, making remission achievable.
  • Predicting sustained response to anti-TNF agents in RA patients remains a significant clinical challenge.

Purpose of the Study:

  • To systematically review existing literature on demographic and clinical factors associated with sustained remission in RA patients treated with anti-TNF therapy.

Main Methods:

  • A systematic literature search was conducted across Embase, Medline, and the Cochrane Controlled Trials Register.
  • Study quality was assessed using Newcastle-Ottawa criteria, with meta-analysis performed where feasible.

Main Results:

  • Concomitant methotrexate use was linked to a higher likelihood of sustained remission.
  • Increased baseline disease activity, tender joint count, age, disease duration, functional impairment, and female sex were associated with a lower likelihood of sustained remission.

Conclusions:

  • Findings support methotrexate co-prescription for RA patients on anti-TNF therapy.
  • Specific demographic and clinical factors negatively impact the achievement of sustained remission, informing realistic treatment expectations and patient selection for dose optimization.

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