Early-onset difficult-to-treat rheumatoid arthritis: proposal of data-driven predictors and temporal threshold
Authors' conclusion
In our cohort, the cut-off time for defining early developers of D2TRA-inefficacy was 44.5 months. The presence of ADS diagnosis, a higher CRP 6 months after the first b/tsDMARD, and being older at diagnosis were predictors of early development of D2TRA.
Study context
- Population
- Difficult-to-treat rheumatoid arthritis (D2TRA) patients whose reason for switching b/tsDMARD therapy was inefficacy (D2TRA-Inneficacy)96 (72.7%) D2TRA-inefficacy
- Participants
- 131 patients
- Exposure
- Early vs late D2TRA-inefficacy developers
- Outcome
- Time to D2TRA-Inneficacy and factors influencing it; cutoff differentiating early and late D2TRA
Methodological detailsLASSO Cox-regression feature selection, DBSCAN clustering, ROC and Precision-Recall curves with Youden index
- LASSO Cox-regression feature selection
- DBSCAN clustering
- ROC and Precision-Recall curves with Youden index
Main finding
As reported in the abstract
Cutoff time differentiating early and late D2TRA
- Optimal cut-off point (Youden index)
- 44.5 months
- DBSCAN clustering identified three clusters, classifying patients into early and late D2TRA
- three
Observational data: associations, not effects.
Original publication
Early-onset difficult-to-treat rheumatoid arthritis: proposal of data-driven predictors and temporal threshold. Arthritis Res Ther. Published 19 July 2025. doi:10.
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