ArticleArthritis research & therapy2020
Clinical predictors of multiple failure to biological therapy in patients with rheumatoid arthritis.
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 31 papers.
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.
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.
Who cites it
31 citing papers in PubMed, 50 citations in OpenAlex.
- RAPID3 disease activity trajectory among patients with rheumatoid arthritis new to specialty pharmacy medications.Journal of managed care & specialty pharmacy · 2026Article
- Clinical and Pharmacogenetic Factors Associated with Response to JAK Inhibitors in Patients with Rheumatoid Arthritis: A Real-World Study ofPharmaceutics · 2026Article
- The Oral-Gut-Immune-Nutrition Axis in Rheumatoid Arthritis: Molecular Mechanisms and Therapeutic Implications.International journal of molecular sciences · 2026Review
- Factors Associated with Difficult-to-Treat Rheumatoid Arthritis (D2T-RA): Real-World Evidence from a Single-Center Cross-Sectional Study.Journal of personalized medicine · 2026Article
- multiDEGGs: Single or Multiomic Differential Network Analysis for Biomarker Discovery and Feature Engineering for Predictive Modeling.Computational and structural biotechnology journal · 2026Article
- Joint Tissues: Convergence and Divergence of the Pathogenetic Mechanisms of Rheumatoid Arthritis and Osteoarthritis.International journal of molecular sciences · 2025Review
- Early-onset difficult-to-treat rheumatoid arthritis: proposal of data-driven predictors and temporal threshold.Arthritis research & therapy · 2025Observational
- Obesity and fibromyalgia are associated with Difficult-to-Treat Rheumatoid Arthritis (D2T-RA) independent of age and gender.Arthritis research & therapy · 2025Article
- Characteristics of patients with difficult-to-treat rheumatoid arthritis: a descriptive retrospective cohort study.Advances in rheumatology (London, England) · 2024Article
- Cost-Effectiveness of Biosimilars vs Leflunomide in Patients With Rheumatoid Arthritis.JAMA network open · 2024Article
- PD-1 signaling uncovers a pathogenic subset of T cells in inflammatory arthritis.Arthritis research & therapy · 2024Article
- Article
- Distinct oral DNA viral signatures in rheumatoid arthritis: a Pilot study.Journal of oral microbiology · 2024Article
- Radiotracers for Imaging of Inflammatory Biomarkers TSPO and COX-2 in the Brain and in the Periphery.International journal of molecular sciences · 2023Review
- Cardiovascular Risk Factors and the Risk of Discontinuation of Advanced Therapies Due to Treatment Failure in Rheumatoid Arthritis: Results From the Ontario Best Practices Research Initiative.ACR open rheumatology · 2023Article
- Development of a scoring model for the Sharp/van der Heijde score using convolutional neural networks and its clinical application.Rheumatology (Oxford, England) · 2023Article
- Neutrophil extracellular trap-associated carbamylation and histones trigger osteoclast formation in rheumatoid arthritis.Annals of the rheumatic diseases · 2023Article
- Clinical Features of Diabetes Mellitus on Rheumatoid Arthritis: Data from the Cardiovascular Obesity and Rheumatic DISease (CORDIS) Study Group.Journal of clinical medicine · 2023Article
- Effectiveness of Yoga and Acupuncture in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis.Evidence-based complementary and alternative medicine : eCAM · 2023Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBiological therapies have improved the clinical course and quality of life of rheumatoid arthritis (RA) patients. Despite the availability and effectiveness of these treatments, some patients experience multiple failures to biologic disease-modifying antirheumatic drugs (bDMARDs), constituting a particular challenge to clinicians.
objectivesThis study aims to determine the percentage of rheumatoid arthritis (RA) patients who fail to respond to subsequent bDMARDs, describe their characteristics, and identify specific baseline and early features during the first bDMARD as possible predictors of consecutive multiple bDMARD failure.
methodsThis is a longitudinal study involving RA patients from the prospective biological cohort drawn from the La Paz University Hospital RA Registry (RA-Paz), starting a bDMARD during the years 2000 to 2019. Patients who presented insufficient response (due to primary or secondary inefficacy) to at least three bDMARDs or two bDMARDs with different mechanism of action were considered multi-refractory (MR-patients). Patients who achieved low disease activity or remission (by DAS-28) with the first bDMARD and maintained this over a follow-up period of at least 5 years were considered non-refractory (NR-patients).
resultsA total of 41 out of 402 (10%) patients were MR-patients and 71 (18%) NR-patients. In the multivariate analysis, the presence of erosions, younger age, higher baseline DAS-28 and mostly achieving delta-DAS < 1.2 after 6 months of the first bDMARD (OR 11.12; 95% CI 3.34-26.82) were independently associated with being MR-patients to bDMARDs.
conclusionsIn our cohort, 10% of patients with RA were observed to have multi-refractoriness to bDMARDs. This study supports the contention that younger patients with erosive disease and especially the early absence of clinical response to the first bDMARDs are predictors of multi-refractoriness to consecutive biologics. Hence, patients with these characteristics should be monitored more closely and may benefit from personalized treatments.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.