The DAS28-ESR cutoff value necessary to achieve remission under the new Boolean-based remission criteria in patients receiving tocilizumabReport as inadecuate




The DAS28-ESR cutoff value necessary to achieve remission under the new Boolean-based remission criteria in patients receiving tocilizumab - Download this document for free, or read online. Document in PDF available to download.

Clinical Rheumatology

, Volume 32, Issue 1, pp 123–127

First Online: 23 October 2012Received: 29 March 2012Revised: 18 August 2012Accepted: 09 October 2012

Abstract

To seek the cutoff value of the 28-joint disease activity score using erythrocyte sedimentation rate DAS28-ESR that is necessary to achieve remission under the new Boolean-based criteria, we analyzed the data for 285 patients with rheumatoid arthritis registered between May 2008 and November 2009 by the Michinoku Tocilizumab Study Group and observed for 1 year after receiving tocilizumab TCZ in real clinical practice. Remission rates under the DAS28-ESR criteria and the Boolean criteria were assessed every 6 months after the first TCZ dose. The DAS28-ESR cutoff value necessary to achieve remission under the new criteria was analyzed by receiver operating characteristic ROC analysis. Data were analyzed using last observation carried forward. After 12 months of TCZ use, remission was achieved in 164 patients 57.5 % by DAS28-ESR and 71 patients 24.9 % under the new criteria for clinical trials. CRP levels scarcely affected remission rates, and the difference between remission rates defined by DAS28-ESR and by the new criteria was mainly due to patient global assessment PGA. Improvement of PGA was inversely related to disease duration. ROC analysis revealed that the DAS28-ESR cutoff value necessary to predict remission under the new criteria for clinical trials was 1.54, with a sensitivity of 88.7 %, specificity of 85.5 %, positive predictive value of 67.0 %, and negative predictive value of 95.8 %. A DAS28-ESR cutoff value of 1.54 may be reasonable to predict achievement of remission under the new Boolean-based criteria for clinical trials in patients receiving TCZ.

KeywordsBoolean Criteria DAS28-ESR Remission Tocilizumab  Download fulltext PDF



Author: Yasuhiko Hirabayashi - Tomonori Ishii - for the Michinoku Tocilizumab Study Group

Source: https://link.springer.com/







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