Actualización 2014 del Documento de Consenso de la Sociedad Española de Reumatología sobre el uso de terapias biológicas en la artritis reumatoide

Sanmartí, Raimón; García-Rodríguez, Susana; Álvaro‐Gracia, José María; Andreu, José Luís; Balsa, Alejandro; Cáliz, Rafael; Fernández‐Nebro, Antonio; Ferraz-Amaro, Iván; Gómez-Reino, Juan J.; González‐Álvaro, Isidoro; Martı́n-Mola, Emilio; Martínez‐Taboada, Víctor M.; Ortiz, Ana M.; Tornero, Jesús; Marsal, Sara; Moreno-Muelas, José Vicente

doi:10.1016/j.reuma.2015.05.001

Cited by 76 publications

(19 citation statements)

References 166 publications

(142 reference statements)

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“…This is an important landmark of HUPI since this level of activity is commonly used to prescribe biological therapy [1,2] as well as to initiate tapering of kind of treatment [22]. …”

Section: Discussionmentioning

confidence: 99%

“…The treat to target (T2T) strategy has improved the outcome of rheumatoid arthritis (RA) and therefore has been included in established RA guidelines [1,2]. In relation to this strategy, there is substantial agreement on considering remission, or low disease activity, as the therapeutic objective for most patients with RA [1,2].…”

Section: Introductionmentioning

confidence: 99%

“…In relation to this strategy, there is substantial agreement on considering remission, or low disease activity, as the therapeutic objective for most patients with RA [1,2]. However, DAS28 and SDAI, the most widely-used indices for defining these targets, have several biases that may interfere with their accuracy [3–6].…”

Section: Introductionmentioning

confidence: 99%

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Cut-Offs and Response Criteria for the Hospital Universitario La Princesa Index (HUPI) and Their Comparison to Widely-Used Indices of Disease Activity in Rheumatoid Arthritis

et al. 2016

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ObjectiveTo estimate cut-off points and to establish response criteria for the Hospital Universitario La Princesa Index (HUPI) in patients with chronic polyarthritis.MethodsTwo cohorts, one of early arthritis (Princesa Early Arthritis Register Longitudinal [PEARL] study) and other of long-term rheumatoid arthritis (Estudio de la Morbilidad y Expresión Clínica de la Artritis Reumatoide [EMECAR]) including altogether 1200 patients were used to determine cut-off values for remission, and for low, moderate and high activity through receiver operating curve (ROC) analysis. The areas under ROC (AUC) were compared to those of validated indexes (SDAI, CDAI, DAS28). ROC analysis was also applied to establish minimal and relevant clinical improvement for HUPI.ResultsThe best cut-off points for HUPI are 2, 5 and 9, classifying RA activity as remission if ≤2, low disease activity if >2 and ≤5), moderate if >5 and <9 and high if ≥9. HUPI’s AUC to discriminate between low-moderate activity was 0.909 and between moderate-high activity 0.887. DAS28’s AUCs were 0.887 and 0.846, respectively; both indices had higher accuracy than SDAI (AUCs: 0.832 and 0.756) and CDAI (AUCs: 0.789 and 0.728). HUPI discriminates remission better than DAS28-ESR in early arthritis, but similarly to SDAI. The HUPI cut-off for minimal clinical improvement was established at 2 and for relevant clinical improvement at 4. Response criteria were established based on these cut-off values.ConclusionsThe cut-offs proposed for HUPI perform adequately in patients with either early or long term arthritis.

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“…This is an important landmark of HUPI since this level of activity is commonly used to prescribe biological therapy [1,2] as well as to initiate tapering of kind of treatment [22]. …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cut-Offs and Response Criteria for the Hospital Universitario La Princesa Index (HUPI) and Their Comparison to Widely-Used Indices of Disease Activity in Rheumatoid Arthritis

et al. 2016

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“…Este planteamiento ha demostrado resultados favorables independientemente de los FAME utilizados y en qué orden se usen 11 , de manera que las estrategias T2T y TC se incluyen entre las recomendaciones actuales para el tratamiento de la AR 14,15 .…”

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“…Un beneficio adicional de la incorporación de los TBiol ha sido que, con sus ensayos pivotales, los reumatólogos aprendimos a hacer un uso apropiado de MTX, de forma que en la actualidad es el FAME clave en el tratamiento de la AR 14,15 . Es más, se ha demostrado que la mayoría de los TBiol en monoterapia no son mejores que MTX cuando este es utilizado adecuadamente [23][24][25] .…”

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