Evidence map›Paper›PMID 34599803›Full record

ArticleRheumatology (Oxford, England)2022

Tumour necrosis factor inhibitor dose adaptation in psoriatic arthritis and axial spondyloarthritis (TAPAS): a retrospective cohort study.

Celia A J Michielsens, Nathan den Broeder, Michelle L M Mulder, Frank H J van den Hoogen, Lise M Verhoef, Alfons A den Broeder

Open access · hybridAbstract read
In one paragraph

Article in Rheumatology (Oxford, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
3.1field-weighted citation impact, top 8% 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

4 citing papers in PubMed, 22 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Anti-TNF dose can be reduced in PsA and axSpA.Nature reviews. Rheumatology · 2021
    Article
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

6 authors at 2 institutions in 1 country.

Celia A J MichielsensDepartment of Rheumatology, Sint Maartenskliniek Nijmegen.ORCID 0000-0001-8625-034X
Nathan den BroederDepartment of Rheumatology, Sint Maartenskliniek Nijmegen.
Michelle L M MulderDepartment of Rheumatology, Sint Maartenskliniek Nijmegen.ORCID 0000-0001-5320-5702
Frank H J van den HoogenDepartment of Rheumatology, Sint Maartenskliniek Nijmegen.
Lise M VerhoefDepartment of Rheumatology, Sint Maartenskliniek Nijmegen.
Alfons A den BroederDepartment of Rheumatology, Sint Maartenskliniek Nijmegen.
Radboud University Nijmegen · NLSint Maartenskliniek · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesWe investigated the effect of disease activity-guided dose optimization (DAGDO) of TNF inhibitor (TNFi) on disease activity and TNFi dose in PsA and axial spondyloarthritis (axSpA) patients with low disease activity (LDA).

methodsA retrospective cohort study was conducted in PsA and axSpA patients doing well on TNFi and eligible for TNFi DAGDO. Three different treatment periods were defined: (i) full dose continuation period, (ii) TNFi DAGDO period, and (iii) period with stable TNFi dose after DAGDO. A mixed-model analysis was used to estimate mean Disease Activity Score 28-joint count CRP (DAS28-CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) during these periods, and a mean percentage of the daily defined dose (%DDD) was calculated as secondary outcome.

resultsThree hundred and twenty-four patients (153 PsA and 171 axSpA) were included, with a mean of 6.5 DAS28-CRP and 6.4 BASDAI measurements and a median follow-up duration of 46 and 44 months, respectively. A corrected difference of 0.06 (95% CI: -0.09, 0.21) in mean DAS28-CRP was found for the TNFi DAGDO period and 0.03 (95% CI: -0.14, 0.20) for the period with stable TNFi dose, compared with full dose continuation period. Differences for BASDAI were 0.03 (95% CI: -0.21, 0.27) and 0.05 (95% CI: -0.24, 0.34), respectively. The mean %DDD for the three treatment periods was for PsA 108%, 62% and 78%, and for axSpA 108%, 62% and 72%, respectively.

conclusionDAGDO of TNFi reduces drug exposure and has no negative effects on disease activity in PsA and axSpA patients compared with full dose continuation.

Indexed as

Antirheumatic AgentsArthritis, PsoriaticAxial SpondyloarthritisSpondylarthritisSpondylitis, AnkylosingC-Reactive ProteinHumansRetrospective StudiesSeverity of Illness IndexTreatment OutcomeTumor Necrosis Factor-alphaTumor Necrosis Factor InhibitorsAntirheumatic AgentsC-Reactive ProteinTumor Necrosis Factor-alphaTumor Necrosis Factor Inhibitorsaxial spondyloarthritisdiscontinuationdisease activity-guideddose optimizationdose reductionpsoriatic arthritisspacingtaperingTNF inhibitorswithdrawal

Identifiers

PMID34599803
PMCPMC9157113
OpenAlexW3202177818

What OpenQuestion holds

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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.