Early clinical response predicts low disease activity at one year in rheumatoid arthritis patients on treatment with certolizumab in real-life settings : an appraisal of the Italian registry GISEA

Objectives The aim of this study was to assess whether good EULAR response assessed at 3 months may predict the achievement of low disease activity (LDA) at 1 year in rheumatoid arthritis (RA) patients on treatment with certolizumab pegol (CZP). Methods From the nationwide Italian registry, we analysed 278 RA patients (age 54.8 ± 12 years, duration of disease 9.8 ± 8 years, female 84%) initiating CZP as first line (68%) or ≥ second line (32%) of biological treatment because of their active disease. Assessment of disease activity was based on 28 joint Disease Activity Score (DAS28). A reduction of DAS28 > 1.2 (good EULAR response) was assessed at 3 months, and the achievement of LDA (DAS28 ≤ 3.2) was evaluated at 1 year. Multiple regression models were used to estimate predictors of early good EULAR response or LDA. Results The percentages of patients attaining good EULAR response were 52% at 3, 65% at 6, and 66% at 12 months. Furthermore, 51.2% (98/192) of the patients reached LDA at 12 months. Patients taking CZP as first biological treatment had adjusted odds ratios (OR) of good EULAR response at 3 months 6 folds higher than in those with ≥ 1 prior biological drug (OR 6.7, 95% CI 1.97–23.1). While, the strongest variable correlating with 12 months LDA was the achievement of good EULAR response at 3 months (OR 11.3, 95% CI 13.1–34.8). Conclusions Our findings showed that attaining good EULAR response at 3 months strongly predicted 1 year LDA in RA patients treated with CZP in real-life settings.