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Early reduction in circulating monocyte count predicts maintenance of remission in patients with rheumatoid arthritis treated with anti-TNF therapy
- Source :
- Annals of the Rheumatic Diseases. 80:1628-1629
- Publication Year :
- 2021
- Publisher :
- BMJ, 2021.
-
Abstract
- Maintenance of remission once achieved is becoming a critical goal for patients with rheumatoid arthritis (RA) as outcomes improve and advances in therapies continue.1 2 Identification of biomarkers to facilitate tailoring of treatment is often linked to modest response criteria, but less frequently to the more stringent target of sustained remission. We have previously implicated monocytes as potential predictor of response to anti-tumour necrosis factor (TNF) through modulation of regulatory T cells, which may promote maintenance of remission through re-establishment of immune tolerance.3 Circulating monocyte numbers are increased in RA but fall in patients who respond to TNF blockade.4 Whether changes in monocyte numbers can also predict loss of remission, once achieved, to anti-TNF therapy is unknown. We therefore addressed whether the change in monocyte counts in the first year from initiation of anti-TNF therapy (baseline) would predict loss of remission (LOR) in patients who achieved sustained remission. We extracted data (June 2020) from two independent cohorts of adult biologic-naive patients with RA who attained sustained remission while treated with anti-TNF between January 2008 and December 2019 (online supplemental table 1). In this retrospective study, Disease Activity Score-28 (DAS28) with erythrocyte sedimentation rate ≤2.6 on at least two occasions (3–6 months apart) after initiation of anti-TNF therapy was used as the definition of remission, as this index was routinely calculated at the treating hospitals. A more stringent definition of remission based on the Clinical Disease Activity Index (CDAI ≤2.8) …
- Subjects :
- 0301 basic medicine
Oncology
medicine.medical_specialty
Immunology
Arthritis
Monocytes
General Biochemistry, Genetics and Molecular Biology
Maintenance Chemotherapy
Arthritis, Rheumatoid
Leukocyte Count
03 medical and health sciences
0302 clinical medicine
Immune system
Rheumatology
Internal medicine
medicine
Humans
Immunology and Allergy
030203 arthritis & rheumatology
medicine.diagnostic_test
business.industry
Monocyte
Remission Induction
Retrospective cohort study
Prognosis
medicine.disease
030104 developmental biology
medicine.anatomical_structure
Erythrocyte sedimentation rate
Rheumatoid arthritis
Tumor Necrosis Factor Inhibitors
Methotrexate
Tumor necrosis factor alpha
business
medicine.drug
Subjects
Details
- ISSN :
- 14682060 and 00034967
- Volume :
- 80
- Database :
- OpenAIRE
- Journal :
- Annals of the Rheumatic Diseases
- Accession number :
- edsair.doi.dedup.....e5ee99b3228b51335f8a43e1f50c78e4