ArticleArthritis research & therapy2020
Insensitivity versus poor response to tumour necrosis factor inhibitors in rheumatoid arthritis: a retrospective cohort study.
Article in Arthritis research & therapy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 24 citations in OpenAlex.
- Trial
- TWEAK receptor (Fn14) exacerbates TNF-α-induced inflammation in rheumatoid arthritis synovial fibroblasts and influences response to anti-TNF-α therapy.Cellular & molecular immunology · 2026Article
- Late Onset Rheumatoid Arthritis.Aging and disease · 2025Review
- Leucine-rich alpha-2-glycoprotein 1 (LRG1) decrement during biologics therapy and its correlation with disease features and treatment outcomes in rheumatoid arthritis patients.Clinical rheumatology · 2025Article
- Late-onset rheumatoid arthritis: clinical features, diagnostic challenges, and treatment approaches.Rheumatology international · 2025Review
- Rheumatoid Factor: Diagnostic and Prognostic Performance and Therapeutic Implications in Rheumatoid Arthritis.Journal of clinical medicine · 2025Review
- Multiscale, mechanistic model of Rheumatoid Arthritis to enable decision making in late stage drug development.NPJ systems biology and applications · 2024Article
- Predictors of functional improvement and pain reduction in rheumatoid arthritis patients who achieved low disease activity with disease-modifying antirheumatic drugs: a retrospective study of the FIRST Registry.Arthritis research & therapy · 2024Article
- Article
- Elderly-Onset Rheumatoid Arthritis: Characteristics and Treatment Options.Medicina (Kaunas, Lithuania) · 2023Review
- Prophylaxis against pneumocystis pneumonia in rheumatoid arthritis patients treated with b/tsDMARDs: insights from 3787 cases in the FIRST registry.Rheumatology (Oxford, England) · 2022Article
- Preferable outcome of Janus kinase inhibitors for a group of difficult-to-treat rheumatoid arthritis patients: from the FIRST Registry.Arthritis research & therapy · 2022Article
- Metabolomics in rheumatoid arthritis: Advances and review.Frontiers in immunology · 2022Review
- Efficacy and safety of tofacitinib versus baricitinib in patients with rheumatoid arthritis in real clinical practice: analyses with propensity score-based inverse probability of treatment weighting.Annals of the rheumatic diseases · 2021Article
- Prediction of response to Certolizumab-Pegol in rheumatoid arthritis (PreCePRA) by functional MRI of the brain - Study protocol for a randomized double-blind controlled study.Contemporary clinical trials communications · 2021Article
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWith advancement in the treatment options of rheumatoid arthritis (RA), optimising the outcomes of difficult-to-treat patients has become increasingly important in clinical practice. In particular, insensitivity to first-line biologic disease-modifying anti-rheumatic drugs (bDMARD) is becoming a significant problem because it may decrease the treatment adherence of patients. This study aimed to compare RA patients with an insensitivity and those with a poor response to initial treatment with tumour necrosis factor inhibitors (TNFis), which are the most frequently used bDMARDs.
methodsThis is a retrospective cohort study using clinical data from the FIRST registry. bDMARD-naïve RA patients treated with tumour necrosis factor inhibitors (TNFis) from August 2003 to May 2019 were included and categorised into three groups: TNFi insensitivity, poor response to TNFis and controls. TNFi insensitivity was defined as follows: (1) discontinuation of TNFi treatment within 22 weeks due to lack of any response, or (2) an increase in the disease activity score in 28 joints-C-reactive protein (DAS28-CRP) of > 0.6 at week 22 compared with week 0. Among the remaining patients, those with a DAS28-CRP > 2.6 at week 22 were categorised in the poor response group.
resultsOf the included patients, 94 were classified in the insensitivity, 604 in the poor response and 915 in the control. A higher DAS28-CRP before treatment was a risk factor for a poor response but not for insensitivity. In contrast, dose escalation of infliximab decreased the risk of a poor response but not that of insensitivity.
conclusionsIn future research, poor and insensitivity to bDMARDs should be assessed separately to fully elucidate the aetiology of, and risk factors for, bDMARD refractoriness.
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