| Title |
Prediction of primary non-response to methotrexate therapy using demographic, clinical and psychosocial variables: results from the UK Rheumatoid Arthritis Medication Study (RAMS)
|
|---|---|
| Published in |
Arthritis Research & Therapy, July 2018
|
| DOI | 10.1186/s13075-018-1645-5 |
| Pubmed ID | |
| Authors |
Jamie C. Sergeant, Kimme L. Hyrich, James Anderson, Kamilla Kopec-Harding, Holly F. Hope, Deborah P. M. Symmons, RAMS Co-Investigators, Anne Barton, Suzanne M. M. Verstappen |
| Abstract |
Methotrexate (MTX) remains the disease-modifying anti-rheumatic drug of first choice in rheumatoid arthritis (RA) but response varies. Predicting non-response to MTX could enable earlier access to alternative or additional medications and control of disease progression. We aimed to identify baseline predictors of non-response to MTX and combine these into a prediction algorithm. This study included patients recruited to the Rheumatoid Arthritis Medication Study (RAMS), a UK multi-centre prospective observational study of patients with RA or undifferentiated polyarthritis, commencing MTX for the first time. Non-response to MTX at 6 months was defined as "no response" using the European League Against Rheumatism (EULAR) response criteria, discontinuation of MTX due to inefficacy or starting biologic therapy. The association of baseline demographic, clinical and psychosocial predictors with non-response was assessed using logistic regression. Predictive performance was assessed using the area under the receiver operating characteristic curve (AUC) and calibration plots. Of 1050 patients, 449 (43%) were classified as non-responders. Independent multivariable predictors of MTX non-response (OR (95% CI)) were rheumatoid factor (RF) negativity (0.62 (0.45, 0.86) for RF positivity versus negativity), higher Health Assessment Questionnaire score (1.64 (1.25, 2.15)), higher tender joint count (1.06 (1.02, 1.10)), lower Disease Activity score in 28 joints (0.29 (0.23, 0.39)) and higher Hospital Anxiety and Depression Scale anxiety score (1.07 (1.03, 1.12)). The optimism-corrected AUC was 0.74. This is the first model for MTX non-response to be developed in a large contemporary study of patients commencing MTX in which demographic, clinical and psychosocial predictors were considered. Patient anxiety was a predictor of non-response and could be addressed at treatment commencement. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Colombia | 2 | 40% |
| Spain | 1 | 20% |
| Unknown | 2 | 40% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 3 | 60% |
| Science communicators (journalists, bloggers, editors) | 1 | 20% |
| Scientists | 1 | 20% |
Mendeley readers
The data shown below were compiled from readership statistics for 108 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 108 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Ph. D. Student | 22 | 20% |
| Student > Master | 13 | 12% |
| Researcher | 11 | 10% |
| Student > Bachelor | 10 | 9% |
| Student > Postgraduate | 6 | 6% |
| Other | 17 | 16% |
| Unknown | 29 | 27% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 33 | 31% |
| Biochemistry, Genetics and Molecular Biology | 11 | 10% |
| Agricultural and Biological Sciences | 7 | 6% |
| Pharmacology, Toxicology and Pharmaceutical Science | 7 | 6% |
| Immunology and Microbiology | 6 | 6% |
| Other | 11 | 10% |
| Unknown | 33 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 31. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 May 2019.
All research outputs
#1,276,886
of 25,385,509 outputs
Outputs from Arthritis Research & Therapy
#126
of 3,381 outputs
Outputs of similar age
#26,794
of 340,113 outputs
Outputs of similar age from Arthritis Research & Therapy
#7
of 73 outputs
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