Concomitant Sjögren's disease as a biomarker for treatment effectiveness in rheumatoid arthritis - results from the Swiss clinical quality management cohort.

Christ, Lisa; Kissling, Seraphina; Finckh, Axel; Fisher, Benjamin A; Adler, Sabine; Maurer, Britta; Möller, Burkhard; Kollert, Florian (2024). Concomitant Sjögren's disease as a biomarker for treatment effectiveness in rheumatoid arthritis - results from the Swiss clinical quality management cohort. Arthritis research & therapy, 26(68) BioMed Central 10.1186/s13075-024-03302-z

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OBJECTIVE

To investigate the clinical phenotype and treatment response in patients with rheumatoid arthritis (RA) with and without concomitant Sjögren's disease (SjD).

METHODS

In this observational cohort study, patients with RA from the Swiss Clinical Quality Management in Rheumatic Diseases registry were categorised according to the presence or absence of SjD. To assess treatment effectiveness, drug retention of tumor necrosis factor-α-inhibitors (TNFi) was compared to other mode of action (OMA) biologics and Janus kinase-inhibitors (JAKi) in RA patients with and without SjD. Adjusted hazard ratios (HR) for time to drug discontinuation were compared in crude and adjusted Cox proportional regression models for potential confounders.

RESULTS

We identified 5974 patients without and 337 patients with concomitant SjD. Patients with SjD were more likely to be female, to have a positive rheumatoid factor, higher disease activity scores, and erosive bone damage. For treatment response, a total of 6781 treatment courses were analysed. After one year, patients with concomitant SjD were less likely to reach DAS28 remission with all three treatment modalities. Patients with concomitant SjD had a higher hazard for stopping TNFi treatment (adjusted HR 1.3 [95% CI 1.07-1.6]; OMA HR 1.12 [0.91-1.37]; JAKi HR 0.97 [0.62-1.53]). When compared to TNFi, patients with concomitant SjD had a significantly lower hazard for stopping treatment with OMA (adjusted HR 0.62 [95% CI 0.46-0.84]) and JAKi (HR 0.52 [0.28-0.96]).

CONCLUSION

RA patients with concomitant SjD reveal a severe RA phenotype, are less responsive to treatment, and more likely to fail TNFi.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology and Immunology

UniBE Contributor:

Christ, Lisa Alexandra, Adler, Sabine, Maurer, Britta, Möller, Burkhard, Kollert, Florian Kim

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1478-6354

Publisher:

BioMed Central

Language:

English

Submitter:

Pubmed Import

Date Deposited:

14 Mar 2024 15:14

Last Modified:

15 Mar 2024 04:22

Publisher DOI:

10.1186/s13075-024-03302-z

PubMed ID:

38481302

Uncontrolled Keywords:

Rheumatoid arthritis Sjögren’s disease Treatment response

BORIS DOI:

10.48350/194270

URI:

https://boris.unibe.ch/id/eprint/194270

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