Effectiveness of tacrolimus in comparison with methotrexate or biologics in propensity score-matched patients with rheumatoid arthritis. Issue 6 (1st November 2016)

• Record Type: Journal Article
• Authors: Nakajima, Ayako; Inoue, Eisuke; Taniguchi, Atsuo; Momohara, Shigeki; Yamanaka, Hisashi
• Is Part Of: Modern rheumatology. Volume 26:Issue 6(2016)
• Page Start: 836
• Page End: 843
• Publication Date: 2016-11-01
• Subjects: Biologics -- Comorbidity -- Methotrexate -- Rheumatoid arthritis -- Tacrolimus; Rheumatology -- Periodicals; 616.723005
• DOI: 10.3109/14397595.2016.1160969
• Languages: English
• ISSNs: 1439-7595

Abstract

Abstract: Objective : To analyze the effectiveness of tacrolimus (TAC) in comparison with methotrexate (MTX) or biologics in propensity score (PS)-matched rheumatoid arthritis (RA) patients. Methods : RA patients with moderate or high disease activity as defined by the 28-joint disease activity score (DAS28) and who had completed at least two successive biannual RA cohort surveys were analyzed. Patients were assigned in a stepwise fashion to one of four groups (Biologics, MTX, TAC, or Control) according to medication changes during a 6-month period. A PS was generated for each of three conditions (Biologics, MTX or Control group versus the TAC group, respectively), followed by the assignment of PS-matched patients. At 1 year, the DAS28 in each treatment versus TAC group was analyzed using a mixed effect model with repeated measures. Results : Compared with the respective PS-matched TAC group, the difference in DAS28 at 1 year was −0.398 [95% confidence interval (CI) − 0.660 to −0.136, p < 0.005] in the Biologics group ( N = 120), −0.045 (95% CI −0.222 to 0.133, p = 0.622) in the MTX group ( N = 465), and 0.182 (95% CI 0.010 to 0.353, p < 0.05) in the Control group ( N = 462). Conclusion : TAC may provide a potential therapeutic option for RA patients with moderate to high disease activity.