Evidence map›Paper›PMID 26483255›Full record

Trial reportAnnals of the rheumatic diseases2016

Prediction of disease relapses by multibiomarker disease activity and autoantibody status in patients with rheumatoid arthritis on tapering DMARD treatment.

Juergen Rech, Axel J Hueber, Stephanie Finzel, Matthias Englbrecht, Judith Haschka, Bernhard Manger, Arnd Kleyer, Michaela Reiser, Jayme Fogagnolo Cobra, Camille Figueiredo and 16 more

Open access · hybridAbstract readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Annals of the rheumatic diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
46citing papers in PubMed, 5 pooled it
8.6field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

46 citing papers in PubMed, 5 syntheses or guidelines pooled it, 93 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors at 10 institutions in 3 countries.

Juergen RechDepartment of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany.
Axel J HueberDepartment of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany.
Stephanie FinzelDepartment of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany.
Matthias EnglbrechtDepartment of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany.
Judith HaschkaDepartment of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany The Vinforce Study Group, Department of Internal Medicine 2, Saint Vincent Hospital, Vienna, Austria.
Bernhard MangerDepartment of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany.
Arnd KleyerDepartment of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany.
Michaela ReiserDepartment of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany.
Jayme Fogagnolo CobraInstituto de Reumatologia de Sao Paulo, Sao Paulo, Brazil.
Camille FigueiredoDepartment of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany Division of Rheumatology, Universidade des Sao Paulo, Sao Paulo, Brazil.
Hans-Peter TonyDepartment of Internal Medicine 2, University of Wurzburg, Wurzburg, Germany.
Stefan KleinertDepartment of Internal Medicine 2, University of Wurzburg, Wurzburg, Germany Rheumatology Practice, Erlangen, Germany.
Joerg WendlerRheumatology Practice, Erlangen, Germany.
Florian SchuchRheumatology Practice, Erlangen, Germany.
Monika RonnebergerRheumatology Practice, Erlangen, Germany.
Martin FeuchtenbergerDepartment of Internal Medicine 2, University of Wurzburg, Wurzburg, Germany Rheumatology Practice and Department of Internal Medicine 2, Clinic Burghausen, Burghausen, Germany.
Martin FleckDepartment of Rheumatology and Clinical Immunology, Asklepios Medical Center, Bad Abbach, Germany.
Karin MangerRheumatology Practice, Bamberg, Germany.
Wolfgang OchsRheumatology Practice, Bayreuth, Germany.
Matthias Schmitt-HaendleRheumatology Practice, Bayreuth, Germany.
Hanns-Martin LorenzDivision of Rheumatology, Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany ACURA Center for Rheumatic Diseases, Baden-Baden, Germany.
Hubert NuessleinRheumatology Practice, Nuremberg, Germany.
Rieke AltenSchlosspark Clinic, Berlin, Germany.
Joerg HenesDepartment of Internal Medicine 2, University of Tubingen, Tubingen, Germany.
Klaus KruegerRheumatology Practice, Munich, Germany.
Georg SchettDepartment of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany.
Friedrich-Alexander-Universität Erlangen-Nürnberg · DEUniversity of Würzburg · DEAcura Kliniken · DEAsklepios Kliniken Bad Abbach · DEMedias Klinikum · DESchlosspark-Klinik · DEUniversidade de São Paulo · BRUniversity of Bamberg · DEUniversity of Tübingen · DEVinforce · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo analyse the role of multibiomarker disease activity (MBDA) score in predicting disease relapses in patients with rheumatoid arthritis (RA) in sustained remission who tapered disease modifying antirheumatic drug (DMARD) therapy in RETRO, a prospective randomised controlled trial.

methodsMBDA scores (scale 1-100) were determined based on 12 inflammation markers in baseline serum samples from 94 patients of the RETRO study. MBDA scores were compared between patients relapsing or remaining in remission when tapering DMARDs. Demographic and disease-specific parameters were included in multivariate logistic regression analysis for defining predictors of relapse.

resultsModerate-to-high MBDA scores were found in 33% of patients with RA overall. Twice as many patients who relapsed (58%) had moderate/high MBDA compared with patients who remained in remission (21%). Baseline MBDA scores were significantly higher in patients with RA who were relapsing than those remaining in stable remission (N=94; p=0.0001) and those tapering/stopping (N=59; p=0.0001). Multivariate regression analysis identified MBDA scores as independent predictor for relapses in addition to anticitrullinated protein antibody (ACPA) status. Relapse rates were low (13%) in patients who were MBDA-/ACPA-, moderate in patients who were MBDA+/ACPA- (33.3%) and MBDA-ACPA+ (31.8%) and high in patients who were MBDA+/ACPA+ (76.4%).

conclusionsMBDA improved the prediction of relapses in patients with RA in stable remission undergoing DMARD tapering. If combined with ACPA testing, MBDA allowed prediction of relapse in more than 80% of the patients. TRIAL REGISTRATION NUMBER: EudraCT 2009-015740-42.

Indexed as

Severity of Illness IndexAdultAgedAntirheumatic AgentsArthritis, RheumatoidAutoantibodiesBiomarkersDisease ProgressionDrug Administration ScheduleFemaleFollow-Up StudiesHumansLogistic ModelsMaleMiddle AgedPeptides, CyclicAntirheumatic AgentsAutoantibodiesBiomarkerscyclic citrullinated peptidePeptides, Cyclic

Identifiers

PMID26483255
PMCPMC5013080
OpenAlexW1810470786

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.