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
N1 - Funding Information:
Acknowledgments The authors thank all medical staff in all institutions for providing the data. This work was supported in part by a Research Grant-In-Aid for Scientific Research by the Ministry of Health, Labor and Welfare of Japan, the Ministry of Education, Culture, Sports, Science and Technology of Japan, and the University of Occupational and Environmental Health, Japan and UOEH Grant for Advanced Research.
Funding Information:
Conflict of interest Y. Tanaka has received consulting fees, speaking fees, and/or honoraria from Mitsubishi-Tanabe, Chugai, Eisai, Takeda, Astellas, and Abbott and has received research grant support from Mitsubishi-Tanabe, Takeda, MSD, Pfizer, Astellas, Chugai, Abbott, and Eisai. H Yamanaka has received Research grant from Chugai Pharmaceutical, Astellas Pharma Inc., Wyeth K. K., Daiichi Sankyo, Banyu Pharmaceutical, Mitsubishi Tanabe Pharma, Abbott Japan, Eisai, Santen Pharmaceutical, Taishotoyama Pharmaceutical, Takeda Pharmaceutical Company Limited, Kissei Pharmaceutical, Janssen Pharmaceutical K.K. and lecture fee and/or consulting fee from Abbott, Eisai, Takeda Pharmaceutical, Mitsubishi Tanabe Pharma, Janssen Pharmaceutical, Hoffmann-La Roche, Chu-gai Pharmaceutical, Pfizer. S Momohara has received speaking fees from Mitsubishi Tanabe Pharma Corporationfrom, Abbott Japan Co., Ltd., and Santen Pharmaceutical Co., Ltd. H. Kameda has received honoraria from Abbott, Centocor Ortho Biotech, Chugai Pharma, Eisai Pharmaceuticals, Mitsubishi Tanabe Pharma, Takeda Pharmaceuticals, Wyeth Japan. K. Amano has received honoraria from Abbott, Chugai Pharmaceutical, Eisai Pharmaceuticals, Mitsubishi Tanabe Pharma, Takeda Pharmaceuticals, Wyeth Japan. T. Takeuchi has received honoraria from the following companies: Abbott, Bristol-Myers Squibb, Chugai Pharmaceutical, Eisai Pharmaceuticals, Janssen Pharmaceutica, Mitsubishi Tanabe Pharma, Novartis, Takeda Pharmaceuticals, Wyeth Japan.
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
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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 - Japanese Journal of Rheumatology
JF - Japanese Journal of Rheumatology
SN - 1439-7595
IS - 2
ER -