Concomitant Sjögren’s disease as a biomarker for treatment effectiveness in rheumatoid arthritis - results from the Swiss clinical quality management cohort
Authors' conclusion
RA patients with concomitant SjD reveal a severe RA phenotype, are less responsive to treatment, and more likely to fail TNFi.
Study context
- Population
- Patients with rheumatoid arthritis (RA) from the Swiss Clinical Quality Management in Rheumatic Diseases registry6,781 treatment courses analysed
- Participants
- 337 vs 5,974
- Exposure
- RA with concomitant Sjögren's disease (SjD) vs RA without SjD; drug retention of TNFi vs other mode of action (OMA) biologics and Janus kinase-inhibitors (JAKi)
- SjDn = 337
- Without SjDn = 5,974reference
- Outcome
- Drug retention (time to drug discontinuation) of TNFi vs OMA biologics and JAKi
Methodological detailsobservational, registry-based, Cox proportional hazards regression, crude and adjusted
- Observational
- Registry-based
- Cox proportional hazards regression, crude and adjusted
Main finding
As reported in the abstract
Hazard of stopping treatment, SjD vs without SjD, by treatment modality
SjD vs Without SjDEstimate (95% CI)
TNFi
adjusted HR 1.3(1.07–1.6)
OMA
HR 1.12(0.91–1.37)
JAKi
HR 0.97(0.62–1.53)
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | |
|---|---|---|
| Hazard of stopping treatment vs TNFi in patients with SjDOMAvs TNFiPatients with SjD | adjusted HR 0.62 (95% CI 0.46–0.84) | |
| Hazard of stopping treatment vs TNFi in patients with SjDJAKivs TNFiPatients with SjD | HR 0.52 (95% CI 0.28–0.96) | |
| 0.20.5125Ratio (log scale) |
DAS28 remission · one year
- Patients with SjD less likely to reach DAS28 remission with all three treatment modalities
Clinical phenotype
- SjD more likely female, RF positive, higher disease activity scores and erosive bone damage
Original publication
Concomitant Sjögren’s disease as a biomarker for treatment effectiveness in rheumatoid arthritis - results from the Swiss clinical quality management cohort. Arthritis Res Ther. Published 14 March 2024. doi:10.
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