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Document type
články
články
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Source: BMČ - články
Title
Short-term response in new users of anti-TNF predicts long-term productivity and non-disability: analysis of Czech ATTRA ankylosing spondylitis biologic registry / J. Tužil, T. Mlčoch, J. Jirčíková, J. Závada, L. Nekvindová, M. Svoboda, M. Uher, Z. Křístková, J. Vencovský, K. Pavelka, T. Doležal,
Author
Tužil, Jan
Institute of Health Economics and Technology Assessment, Prague, Czech Republic. 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.

Mlčoch, Tomáš
Institute of Health Economics and Technology Assessment, Prague, Czech Republic.

Jirčíková, Jitka
Institute of Health Economics and Technology Assessment, Prague, Czech Republic.

Závada, Jakub
1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic. Institute of Rheumatology, Prague, Czech Republic.

Nekvindová, Lucie
1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic. Institute of Biostatistics and Analyses, Ltd., Spinoff company of the Faculty of Medicine of the Masaryk University, Brno, Czech Republic.

Svoboda, Michal
Institute of Biostatistics and Analyses, Ltd., Spinoff company of the Faculty of Medicine of the Masaryk University, Brno, Czech Republic.

Uher, Michal
Faculty of Medicine of the Masaryk University, Institute of Biostatistics and Analyses, Brno, Czech Republic.

Křístková, Zlatuše
Institute of Biostatistics and Analyses, Ltd., Spinoff company of the Faculty of Medicine of the Masaryk University, Brno, Czech Republic.

Vencovský, Jiří
1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic. Institute of Rheumatology, Prague, Czech Republic.

Pavelka, Karel
1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic. Institute of Rheumatology, Prague, Czech Republic.

Doležal, Tomáš
Institute of Health Economics and Technology Assessment, Prague, Czech Republic. Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.

Cited source
Expert opinion on biological therapy. 2020, roč. 20, č. 2, s. 183-192. ISSN: 1471-2598; (OCoLC)48476209; 1744-7682 (online).
Date of issue
2020
Language
angličtina
Country
Spojené království
Document type
články
DOI
Pubmed ID
Link
Record number
bmc20028549
Persistent link
English Abstract
Objectives: To assess the role of short-term response to first anti-TNF in long-term prediction of disability.Methods: In nationwide registry ATTRA, we identified ankylosing spondylitis patients starting anti-TNF between 01/2003 and 12/2016. Full disability and work impairment (WI; WPAI questionnaire) were predicted via the Cox- and lagged-parameter mixed-effect regression.Results: 2,274 biologicals-naïve patients newly indicated to anti-TNF were prospectively followed (6,333 patient-years; median follow-up 1.9 years). Reaching BASDAI < 4 (77.4%) and ASDAS-CRP < 2.1 (61.1%) after 3 months of anti-TNF both decreased the risk of future disability by ≈2.5-fold. ASDAS-CRP < 2.1 predicted non-disability better than BASDAI < 4 & CRP < 5 mg/L (p = 0.032). BASDAI < 4 & CRP < 5 mg/L was comparable to BASDAI < 4 (p = 0.941) and to BASDAI change by >50% or by >2 points (p = 0.902). ASDAS-CRP change >1.1 and >2.0 both failed to predict non-disability. Once on anti-TNF therapy, the strongest predictor of WI was Pain (SF36). Yearly increase in indirect costs remains below €3,000 in those reaching ASDAS-CRP < 2.1.Conclusions: Low disease activity measured by ASDAS-CRP ≤ 2.1 should be used to measure the outcome of new anti-TNF therapy. Continuous WI could be decreased through pain management.
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