Utilizing biologic disease-modifying anti-rheumatic treatment sequences to subphenotype rheumatoid arthritis
Authors' conclusion
We observed that RA subjects can be clustered based on the sequence of b/tsDMARD prescriptions over time and that the clusters were correlated with differing trajectories of disease activity over time.
Study context
- Population
- Patients with rheumatoid arthritis (RA) prescribed ≥ 1 bDMARD or tsDMARD in a validated EHR-based RA cohort, January 1, 2008, through July 31, 2019 (mean age 52 years, RA duration 3.4 years, 62% seropositive)550 unique b/tsDMARD sequences
- Participants
- 2,172 patients
- Exposure
- Clusters of RA patients derived from b/tsDMARD prescription sequences
- Outcome
- Distinct clusters of RA patients based on b/tsDMARD prescription history
Methodological detailselectronic health record-based cohort, Markov chain clustering (maximum likelihood estimator (MLE)-based), linked registry of prospectively collected clinical disease activity index (CDAI)
- Electronic health record-based cohort
- Markov chain clustering (MLE-based)
- Linked registry of prospectively collected CDAI
Main finding
As reported in the abstract
Cluster membership (proportion of patients)
Observational data: associations, not effects.
Further findings
- Compared to the other groups, TNFi persisters had the most favorable trajectory of CDAI over time
Original publication
Utilizing biologic disease-modifying anti-rheumatic treatment sequences to subphenotype rheumatoid arthritis. Arthritis Res Ther. Published 2 June 2023. doi:10.
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