Structural damages disturb functional improvement in patients with rheumatoid arthritis treated with etanercept

Yoshiya Tanaka, Hisashi Yamanaka, Kazuyoshi Saito, Shigeru Iwata, Ippei Miyagawa, Yohei Seto, Shigeki Momohara, Hayato Nagasawa, Hideto Kameda, Yuko Kaneko, Keisuke Izumi, Koichi Amano, Tsutomu Takeuchi

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Tumor necrosis factor (TNF) inhibitors have produced improvements in clinical, radiographic, and functional outcomes in rheumatoid arthritis (RA) patients. However, it remains unclear whether factors affecting physical functions remain following TNF therapy. The objective of our study was to assess factors affecting improvement of physical functions and to shed light on relations to disease activity and structural changes in patients with RA treated with etanercept. The study enrolled 208 patients, all of whose composite measures regarding clinical, radiographic, and functional estimation both at 0 and 52 weeks after etanercept therapy were completed. Mean disease duration of 208 patients was 9.6 years, mean Disease Activity Score for 28 joints (DAS28) was 5.4, and mean van der Heijde modified total Sharp score (mTSS) was 94.6. Mean Health Assessment Questionnaire Disability Index (HAQ-DI) improved from 1.4 at 0 weeks to 1.0 at 52 weeks after etanercept therapy, a 31% reduction, which was much less than changes in DAS28 and mTSS. By multivariate analysis, HAQ-DI and mTSS at baseline were significantly correlated HAQ remission. Median HAQ-DI improved in 100 versus 20% of the HAQ-DI ≤0.6 versus ≥2.0 groups, respectively. The mTSS cutoff point at baseline to obtain HAQ remission was 55.5. During etanercept treatment in the mTSS <55.5 versus >55.5 groups, median HAQ-DI improved in 70 versus 39%; remission was achieved in 59 versus 33%; and there was no improvement in 14 versus 30%, respectively. HAQ-DI improvement was significantly correlated with that of DAS28 but not of mTSS. In conclusion, higher HAQ and mTSS at baseline inhibits HAQ-DI improvement within 1 year of etanercept treatment, and the cutoff point necessary for mTSS to improve physical functions in patients with RA was 55.5.

Original languageEnglish
Pages (from-to)186-194
Number of pages9
JournalModern Rheumatology
Volume22
Issue number2
DOIs
Publication statusPublished - 2012 Apr

Fingerprint

ametantrone
Rheumatoid Arthritis
Health
Joints
Tumor Necrosis Factor-alpha
Therapeutics
Surveys and Questionnaires
Etanercept
Multivariate Analysis

Keywords

  • Anti-TNF
  • Disease activity
  • Physical function
  • Rheumatoid arthritis
  • Treatment

ASJC Scopus subject areas

  • Rheumatology

Cite this

Structural damages disturb functional improvement in patients with rheumatoid arthritis treated with etanercept. / Tanaka, Yoshiya; Yamanaka, Hisashi; Saito, Kazuyoshi; Iwata, Shigeru; Miyagawa, Ippei; Seto, Yohei; Momohara, Shigeki; Nagasawa, Hayato; Kameda, Hideto; Kaneko, Yuko; Izumi, Keisuke; Amano, Koichi; Takeuchi, Tsutomu.

In: Modern Rheumatology, Vol. 22, No. 2, 04.2012, p. 186-194.

Research output: Contribution to journalArticle

Tanaka, Y, Yamanaka, H, Saito, K, Iwata, S, Miyagawa, I, Seto, Y, Momohara, S, Nagasawa, H, Kameda, H, Kaneko, Y, Izumi, K, Amano, K & Takeuchi, T 2012, 'Structural damages disturb functional improvement in patients with rheumatoid arthritis treated with etanercept', Modern Rheumatology, vol. 22, no. 2, pp. 186-194. https://doi.org/10.1007/s10165-011-0510-z
Tanaka, Yoshiya ; Yamanaka, Hisashi ; Saito, Kazuyoshi ; Iwata, Shigeru ; Miyagawa, Ippei ; Seto, Yohei ; Momohara, Shigeki ; Nagasawa, Hayato ; Kameda, Hideto ; Kaneko, Yuko ; Izumi, Keisuke ; Amano, Koichi ; Takeuchi, Tsutomu. / Structural damages disturb functional improvement in patients with rheumatoid arthritis treated with etanercept. In: Modern Rheumatology. 2012 ; Vol. 22, No. 2. pp. 186-194.
@article{c5bf4d6d50f64d8f9c25b30e57aa1609,
title = "Structural damages disturb functional improvement in patients with rheumatoid arthritis treated with etanercept",
abstract = "Tumor necrosis factor (TNF) inhibitors have produced improvements in clinical, radiographic, and functional outcomes in rheumatoid arthritis (RA) patients. However, it remains unclear whether factors affecting physical functions remain following TNF therapy. The objective of our study was to assess factors affecting improvement of physical functions and to shed light on relations to disease activity and structural changes in patients with RA treated with etanercept. The study enrolled 208 patients, all of whose composite measures regarding clinical, radiographic, and functional estimation both at 0 and 52 weeks after etanercept therapy were completed. Mean disease duration of 208 patients was 9.6 years, mean Disease Activity Score for 28 joints (DAS28) was 5.4, and mean van der Heijde modified total Sharp score (mTSS) was 94.6. Mean Health Assessment Questionnaire Disability Index (HAQ-DI) improved from 1.4 at 0 weeks to 1.0 at 52 weeks after etanercept therapy, a 31{\%} reduction, which was much less than changes in DAS28 and mTSS. By multivariate analysis, HAQ-DI and mTSS at baseline were significantly correlated HAQ remission. Median HAQ-DI improved in 100 versus 20{\%} of the HAQ-DI ≤0.6 versus ≥2.0 groups, respectively. The mTSS cutoff point at baseline to obtain HAQ remission was 55.5. During etanercept treatment in the mTSS <55.5 versus >55.5 groups, median HAQ-DI improved in 70 versus 39{\%}; remission was achieved in 59 versus 33{\%}; and there was no improvement in 14 versus 30{\%}, respectively. HAQ-DI improvement was significantly correlated with that of DAS28 but not of mTSS. In conclusion, higher HAQ and mTSS at baseline inhibits HAQ-DI improvement within 1 year of etanercept treatment, and the cutoff point necessary for mTSS to improve physical functions in patients with RA was 55.5.",
keywords = "Anti-TNF, Disease activity, Physical function, Rheumatoid arthritis, Treatment",
author = "Yoshiya Tanaka and Hisashi Yamanaka and Kazuyoshi Saito and Shigeru Iwata and Ippei Miyagawa and Yohei Seto and Shigeki Momohara and Hayato Nagasawa and Hideto Kameda and Yuko Kaneko and Keisuke Izumi and Koichi Amano and Tsutomu Takeuchi",
year = "2012",
month = "4",
doi = "10.1007/s10165-011-0510-z",
language = "English",
volume = "22",
pages = "186--194",
journal = "Modern Rheumatology",
issn = "1439-7595",
publisher = "Springer Japan",
number = "2",

}

TY - JOUR

T1 - Structural damages disturb functional improvement in patients with rheumatoid arthritis treated with etanercept

AU - Tanaka, Yoshiya

AU - Yamanaka, Hisashi

AU - Saito, Kazuyoshi

AU - Iwata, Shigeru

AU - Miyagawa, Ippei

AU - Seto, Yohei

AU - Momohara, Shigeki

AU - Nagasawa, Hayato

AU - Kameda, Hideto

AU - Kaneko, Yuko

AU - Izumi, Keisuke

AU - Amano, Koichi

AU - Takeuchi, Tsutomu

PY - 2012/4

Y1 - 2012/4

N2 - Tumor necrosis factor (TNF) inhibitors have produced improvements in clinical, radiographic, and functional outcomes in rheumatoid arthritis (RA) patients. However, it remains unclear whether factors affecting physical functions remain following TNF therapy. The objective of our study was to assess factors affecting improvement of physical functions and to shed light on relations to disease activity and structural changes in patients with RA treated with etanercept. The study enrolled 208 patients, all of whose composite measures regarding clinical, radiographic, and functional estimation both at 0 and 52 weeks after etanercept therapy were completed. Mean disease duration of 208 patients was 9.6 years, mean Disease Activity Score for 28 joints (DAS28) was 5.4, and mean van der Heijde modified total Sharp score (mTSS) was 94.6. Mean Health Assessment Questionnaire Disability Index (HAQ-DI) improved from 1.4 at 0 weeks to 1.0 at 52 weeks after etanercept therapy, a 31% reduction, which was much less than changes in DAS28 and mTSS. By multivariate analysis, HAQ-DI and mTSS at baseline were significantly correlated HAQ remission. Median HAQ-DI improved in 100 versus 20% of the HAQ-DI ≤0.6 versus ≥2.0 groups, respectively. The mTSS cutoff point at baseline to obtain HAQ remission was 55.5. During etanercept treatment in the mTSS <55.5 versus >55.5 groups, median HAQ-DI improved in 70 versus 39%; remission was achieved in 59 versus 33%; and there was no improvement in 14 versus 30%, respectively. HAQ-DI improvement was significantly correlated with that of DAS28 but not of mTSS. In conclusion, higher HAQ and mTSS at baseline inhibits HAQ-DI improvement within 1 year of etanercept treatment, and the cutoff point necessary for mTSS to improve physical functions in patients with RA was 55.5.

AB - Tumor necrosis factor (TNF) inhibitors have produced improvements in clinical, radiographic, and functional outcomes in rheumatoid arthritis (RA) patients. However, it remains unclear whether factors affecting physical functions remain following TNF therapy. The objective of our study was to assess factors affecting improvement of physical functions and to shed light on relations to disease activity and structural changes in patients with RA treated with etanercept. The study enrolled 208 patients, all of whose composite measures regarding clinical, radiographic, and functional estimation both at 0 and 52 weeks after etanercept therapy were completed. Mean disease duration of 208 patients was 9.6 years, mean Disease Activity Score for 28 joints (DAS28) was 5.4, and mean van der Heijde modified total Sharp score (mTSS) was 94.6. Mean Health Assessment Questionnaire Disability Index (HAQ-DI) improved from 1.4 at 0 weeks to 1.0 at 52 weeks after etanercept therapy, a 31% reduction, which was much less than changes in DAS28 and mTSS. By multivariate analysis, HAQ-DI and mTSS at baseline were significantly correlated HAQ remission. Median HAQ-DI improved in 100 versus 20% of the HAQ-DI ≤0.6 versus ≥2.0 groups, respectively. The mTSS cutoff point at baseline to obtain HAQ remission was 55.5. During etanercept treatment in the mTSS <55.5 versus >55.5 groups, median HAQ-DI improved in 70 versus 39%; remission was achieved in 59 versus 33%; and there was no improvement in 14 versus 30%, respectively. HAQ-DI improvement was significantly correlated with that of DAS28 but not of mTSS. In conclusion, higher HAQ and mTSS at baseline inhibits HAQ-DI improvement within 1 year of etanercept treatment, and the cutoff point necessary for mTSS to improve physical functions in patients with RA was 55.5.

KW - Anti-TNF

KW - Disease activity

KW - Physical function

KW - Rheumatoid arthritis

KW - Treatment

UR - http://www.scopus.com/inward/record.url?scp=84861483067&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84861483067&partnerID=8YFLogxK

U2 - 10.1007/s10165-011-0510-z

DO - 10.1007/s10165-011-0510-z

M3 - Article

C2 - 21901357

AN - SCOPUS:84861483067

VL - 22

SP - 186

EP - 194

JO - Modern Rheumatology

JF - Modern Rheumatology

SN - 1439-7595

IS - 2

ER -