Effectiveness and persistence of biological and targeted synthetic treatment in patients with rheumatoid arthritis and chronic kidney disease: a multicentre, prospective cohort study
Authors' conclusion
Although biological and targeted synthetic DMARDs are generally well tolerated and effective options, patients with rheumatoid arthritis and reduced eGFR have lower likelihood of attaining remission.
Study context
- Population
- Patients with RA and moderate or high disease activity (Clinical Disease Activity Index (CDAI) >10) initiating b/tsDMARDs (TNFi, CTLA4 immunoglobulin, IL-6 inhibitors, B-cell depletion therapy, JAKi), CorEvitas RA registry, 160 rheumatology practices in the USA, 2001–20239,601 patients
- Participants
- 12,123 patients
- Exposure
- Reduced estimated glomerular filtration rate (eGFR) vs preserved eGFR in patients with RA initiating b/tsDMARDs
- Reduced eGFRn = 1,266
- Preserved eGFRn = 10,857reference
- Outcome
- Attainment of remission according to CDAI score
Methodological detailsmulticentre, propensity-score overlap weighting, Cox regression
- Multicentre
- Propensity-score overlap weighting
- Cox regression
Main finding
As reported in the abstract
CDAI-based remission
Reduced eGFR vs Preserved eGFREstimate (95% CI)
CDAI-based remission
unadjusted HR for attaining CDAI-based remission 0.71(0.62–0.82)
Propensity-score overlap weighting
adjusted HR for attaining CDAI-based remission 0.76(0.66–0.88)
Observational data: associations, not effects.
Original publication
Effectiveness and persistence of biological and targeted synthetic treatment in patients with rheumatoid arthritis and chronic kidney disease: a multicentre, prospective cohort study. Lancet Rheumatol. Published 22 April 2026. doi:10.
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