2026-08-05T15:43:21Zhttps://repisalud.isciii.es/rest/oai/requestoai:repisalud.isciii.es:20.500.12105/115912024-10-31T11:44:50Zcom_20.500.12105_19604com_20.500.12105_2051col_20.500.12105_19607
Repisalud
author
Novella-Navarro, Marta
author
Plasencia, Chamaida
author
Tornero, Carolina
author
Navarro-Compán, Victoria
author
Cabrera-Alarcón, José Luis
author
Peiteado-López, Diana
author
Nuño, Laura
author
Monjo-Henry, Irene
author
Franco-Gómez, Karen
author
Villalba, Alejandro
author
Balsa, Alejandro
2021-01-08T15:48:00Z
2021-01-08T15:48:00Z
2020-12-09
Arthritis Res Ther. 2020; 22(1):284
10.1186/s13075-020-02354-1
1478-6354
Arthritis research & therapy
33298140
http://hdl.handle.net/20.500.12105/11591
Biological therapies have improved the clinical course and quality of life of rheumatoid arthritis (RA) patients. Despite the availability and effectiveness of these treatments, some patients experience multiple failures to biologic disease-modifying antirheumatic drugs (bDMARDs), constituting a particular challenge to clinicians.
This study aims to determine the percentage of rheumatoid arthritis (RA) patients who fail to respond to subsequent bDMARDs, describe their characteristics, and identify specific baseline and early features during the first bDMARD as possible predictors of consecutive multiple bDMARD failure.
This is a longitudinal study involving RA patients from the prospective biological cohort drawn from the La Paz University Hospital RA Registry (RA-Paz), starting a bDMARD during the years 2000 to 2019. Patients who presented insufficient response (due to primary or secondary inefficacy) to at least three bDMARDs or two bDMARDs with different mechanism of action were considered multi-refractory (MR-patients). Patients who achieved low disease activity or remission (by DAS-28) with the first bDMARD and maintained this over a follow-up period of at least 5 years were considered non-refractory (NR-patients).
A total of 41 out of 402 (10%) patients were MR-patients and 71 (18%) NR-patients. In the multivariate analysis, the presence of erosions, younger age, higher baseline DAS-28 and mostly achieving delta-DAS < 1.2 after 6 months of the first bDMARD (OR 11.12; 95% CI 3.34-26.82) were independently associated with being MR-patients to bDMARDs.
In our cohort, 10% of patients with RA were observed to have multi-refractoriness to bDMARDs. This study supports the contention that younger patients with erosive disease and especially the early absence of clinical response to the first bDMARDs are predictors of multi-refractoriness to consecutive biologics. Hence, patients with these characteristics should be monitored more closely and may benefit from personalized treatments.
eng
Clinical predictors of multiple failure to biological therapy in patients with rheumatoid arthritis.
journal article
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