Accès ouvert déclaré
2023
article
Socioeconomic deprivation is associated with reduced response and lower treatment persistence with TNF inhibitors in rheumatoid arthritis
Sizheng Steven Zhao, Kira Rogers, Lianne Kearsley‐Fleet, Kath Watson, James Galloway, Suzanne Verstappen, Darren Plant, Hill Gaston, D. Mulherin, T Price, Thomas Sheeran, V Chalam, Sivasubramanian Baskar, P Emery, A Morgan, MH Buch, Sarah Bingham, Siobhan Reilly, Louisa J Badcock, Marian Regan, T. Ding, Chris Deighton, Gregory D. Summers, N. Raj, Randall M. Stevens, Nicola Williams, John D. Isaacs, Philip Platt, Douglas G. Walker, Lesley Kay, Bethany E. Griffiths, Wan‐Fai Ng, Paul Peterson, Alice Lorenzi, Helen Foster, Mark Friswell, B Thompson, Michael Lee, I Griffiths, A Hassell, Piers Dawes, C Dowson, Sanjeet Kamath, Jon Packham, M F Shadforth, Ann Brownfield, Richard Williams, Chetan Mukhtyar, Beverley Harrison, Neil Snowden, Saima Naz, Joanna Ledingham, R G Hull, F McCrae, Audrey Alforque Thomas, Sang-Yeon Min, Ramon Z. Shaban, E Wong, Carol Kelly, C. Heycock, J. Hamilton, V. Saravanan, Gillian Wilson, Daniel V. Bax, Lisa Dunkley, M Akil, Rachel Tattersall, Rachael Kilding, Simon Till, J. Boulton, T Tait, Marwan Bukhari, Jim Halsey, L Ottewell, Christopher D. Buckley, Deva Situnayake, DOUGLAS G. CARRUTHERS, K A Grindulis, F Khatack, Srinivasa Elamanchi, Karim Raza, Andrew Filer, R. W. Jubb, Robert S. Abernathy, Michael Plant, Sanjay Pathare, Fiona Clarke, Stephen Tuck, J N Fordham, Alok Kumar Paul, M Bridges, Ando Fikri Hakim, D O hx Reilly, Vivek Rajagopal, Shweta Bhagat, C. J. Edwards, P. Prouse, R Moitra, D Shawe, Andrew Bamji, P S Klimiuk, A P Bowden, William Mitchell, Ian N Bruce, Anne Barton, Rachel Gorodkin, Pauline Ho, Kimme L Hyrich, W. E. Dixon, Ankit Rai, George D. Kitas, Nicola Erb, Rainer Klocke, Karen Douglas, A Pace, Roopinder K. Sandhu, A Whallett, Fraser Birrell, Maggie Allen, К. Ray Chaudhuri, C Chattopadhyay, J F McHale, A Jones, Annie Gupta, Ira Pande, Ian Gaywood, Peter Lanyon, P Courtney, M Doherty, Hector Chinoy, T O hx Neill, Ariane L. Herrick, Robert G. Cooper, R C Bucknall, Christopher Marguerie, S. Rigby, Nathan Dunn, S Green, Aliya Al-Ansari, S Webber, Neil Hopkinson, Colum Dunne, Brian Quilty, B Szebenyi, Michael Green, M. Quinn, A. H. Isdale, Andrew K. Brown, Benazir Saleem, A Samanta, P Sheldon, W Hassan, James N. Francis, Alison Kinder, R Neame, A Moorthy, W Al-Allaf, A. J. Taggart, Kevin Fairburn, Frank McKenna, Andrew Gough, CA Lawson, Margaret Piper, Eleanor Korendowych, T Jenkinson, Raj Sengupta, A K Bhalla, Neil McHugh, Dale S. Bond, Raashid Luqmani, B Bowness, Paul Wordsworth, Joseph David, W. P. Smith, Devesh Mewar, E J Tunn, K Nelson, Tom D. Kennedy, Jennifer Nixon, Anthony D. Woolf, M Davis, David Hutchinson, Alison Endean, David Coady, D. Wright, Craig Morley, Graham Raftery, C. Bracewell, L Kidd, I Abbas, Charlotte Filer, G Kallarackal, Jennifer Humphreys
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1Pays d’affiliation déclarés
Rattachement africain : gb.
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Le résumé fourni par la source
OBJECTIVE: To investigate the association between socioeconomic deprivation and outcomes following TNF inhibitor (TNFi) treatment. METHODS: Individuals commencing their first TNFi in the British Society for Rheumatology Biologics Register for RA (BSRBR-RA) and Biologics in RA Genetics and Genomics Study Syndicate (BRAGGSS) cohort were included. Socioeconomic deprivation was proxied using the Index of Multiple Deprivation and categorized as 20% most deprived, middle 40% or 40% least deprived. DAS28-derived outcomes at 6 months (BSRBR-RA) and 3 months (BRAGGSS) were compared using regression models with the least deprived as referent. Risks of all-cause and cause-specific drug discontinuation were compared using Cox models in the BSRBR-RA. Additional analyses adjusted for lifestyle factors (e.g. smoking, BMI) as potential mediators. RESULTS: 16 085 individuals in the BSRBR-RA were included (mean age 56 years, 76% female), of whom 18%, 41% and 41% were in the most, middle and least deprived groups, respectively. Of 3459 included in BRAGGSS (mean age 57, 77% female), proportions were 22%, 36% and 41%, respectively. The most deprived group had 0.3-unit higher 6-month DAS28 (95% CI 0.22, 0.37) and were less likely to achieve low disease activity (odds ratio [OR] 0.76; 95% CI 0.68, 0.84) in unadjusted models. Results were similar for 3-month DAS28 (β = 0.23; 95% CI 0.11, 0.36) and low disease activity (OR 0.77; 95% CI 0.63, 0.94). The most deprived were more likely to discontinue treatment (hazard ratio 1.18; 95% CI 1.12, 1.25), driven by ineffectiveness rather than adverse events. Adjusted estimates were generally attenuated. CONCLUSION: Socioeconomic deprivation is associated with reduced response to TNFi. Improvements in determinants of health other than lifestyle factors are needed to address socioeconomic inequities.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Socioeconomic deprivation is associated with reduced response and lower treatment persistence with TNF inhibitors in rheumatoid arthritis
- Date Crossref
- 02/06/2023
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Les institutions déclarées
Une affiliation ne permet pas de déduire la nationalité d’un auteur.
Les sujets associés
Rheumatoid Arthritis Research and TherapiesSpondyloarthritis Studies and TreatmentsAutoimmune and Inflammatory Disorders Research