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Current Tumor Necrosis Factor-a Inhibitor Use Is Associated with a Higher Probability of Remissions in Patients with Rheumatoid Arthritis

GEORGE C. LIANG, MAGALY CORDERO, ALAN DYER, and ROWLAND W. CHANG

ABSTRACT.

Objective.
To determine if current tumor necrosis factor-α (TNF-α) inhibitor use is associated with a higher probability of remission than non-use in patients with rheumatoid arthritis (RA).

Methods. Clinical and demographic data were collected from 322 patients with RA during regularly scheduled clinic visits. Current and past medications were recorded. Disease activity status (remission or not) was determined using American College of Rheumatology preliminary criteria for clinical remission of RA. A logistic regression analysis was used to calculate crude and adjusted odds ratios (OR) for remission for current TNF-α inhibitor users versus non-users. Multivariate analysis included age, gender, race, disease duration, use of nonsteroidal antiinflammatory drugs (NSAID), prednisone dosage, and numbers of previously used disease modifying antirheumatic drugs (DMARD).

Results. Of the 111 patients enrolled in the study who were users of TNF-α inhibitors, 25.2% were found to be in clinical remission. Of the 211 patients who were non-users, 14.7% were in clinical remission. The unadjusted OR for remission in TNF-α inhibitor users was 1.96 (95% confidence interval, CI: 1.10 to 3.48). The adjusted OR was 2.74 (95% CI: 1.40 to 5.34).

Conclusion. Cross-sectional observations from an outpatient arthritis clinic found a significantly higher remission rate in patients with RA taking a TNF-α inhibitor compared to non-users. (J Rheumatol 2005;32:1662-5)

Key Indexing Terms:

TNF-α INHIBITOR
RHEUMATOID ARTHRITIS
REMISSION RATES
CROSS-SECTIONAL STUDY
TREATMENT


From the Departments of Medicine (Rheumatology Division) and Preventive Medicine, Multidisciplinary Clinical Research Center in Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Supported by the Women's Board of Northwestern Memorial Hospital Small Grant Initiative, Pfizer Inc., Wyeth Pharmaceutical, and NIH (NIAMS) Grant P60 AR48098.

G.C. Liang, MD; M. Cordero, A. Dyer Ph.D, R.W. Chang, MD.

Address reprint requests to Dr. G.C. Liang, 240 E. Huron Street, Suite 2300, McGaw Pavilion, Chicago, IL 60611. E-mail: gcliang@northwestern.edu

Accepted for publication April 18, 2005.




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