PMID- 34135268 OWN - NLM STAT- MEDLINE DCOM- 20210618 LR - 20210713 IS - 1349-7235 (Electronic) IS - 0918-2918 (Print) IS - 0918-2918 (Linking) VI - 60 IP - 12 DP - 2021 TI - Scoring Model to Predict a Low Disease Activity in Elderly Rheumatoid Arthritis Patients Initially Treated with Biological Disease-modifying Antirheumatic Drugs. PG - 1827-1834 LID - 10.2169/internalmedicine.6251-20 [doi] AB - Objective We aimed to develop a scoring model to predict a low disease activity (LDA) in elderly rheumatoid arthritis (RA) patients initially treated with biological disease-modifying antirheumatic drugs (bDMARDs). Methods This retrospective cohort study included 82 elderly RA patients who initially received bDMARDs. The outcome was an LDA after bDMARDs initiation. We developed a predictive formula for an LDA using a multivariate analysis, the accuracy of which was assessed by the area under the curve (AUC) of the receiver operating characteristic curves; the scoring model was developed using the formula. For each factor, approximate odds ratios were scored as an integer, divided into three groups based on the distribution of these scores. In addition, the scoring model accuracy was assessed. Results The mean age was 73.5+/-6.0 years old, and 86.6% were women. An LDA was achieved in 43 patients (52.4%). The predictive formula for an LDA was prepared using six factors selected for the multivariable analysis: the neutrophil-to-lymphocyte ratio (NLR), anemia, the 28-joint disease activity score with erythrocyte sedimentation rate (DAS28-ESR), serum level of matrix metalloproteinase-3 (MMP-3), diabetes mellitus (DM), and rheumatoid factor (RF). The AUC for the formula was 0.829 (95% confidence interval, 0.729-0.930). The odds ratios of the six factors were scored (DAS28-ESR and serum MMP-3=1 point, NLR, anemia, DM, and RF=2 points) and divided into three groups (/=8). The high-score group (>/=8) achieved a positive predictive value of 83%. Conclusion The scoring model accurately predicted an LDA in elderly RA patients initially treated with bDMARDs. FAU - Okada, Takahiro AU - Okada T AD - Division of Pharmacotherapeutics, Department of Clinical Pharmacy, Showa University School of Pharmacy, Japan. FAU - Kohyama, Noriko AU - Kohyama N AD - Division of Pharmacotherapeutics, Department of Clinical Pharmacy, Showa University School of Pharmacy, Japan. FAU - Takenaka, Miki AU - Takenaka M AD - Division of Pharmacotherapeutics, Department of Clinical Pharmacy, Showa University School of Pharmacy, Japan. FAU - Yamaguchi, Takashi AU - Yamaguchi T AD - Division of Pharmacotherapeutics, Department of Clinical Pharmacy, Showa University School of Pharmacy, Japan. FAU - Kurihara, Tatsuya AU - Kurihara T AD - Division of Natural Medicine and Therapeutics, Department of Clinical Pharmacy, Showa University School of Pharmacy, Japan. FAU - Sakurai, Kosuke AU - Sakurai K AD - Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Japan. FAU - Miwa, Yusuke AU - Miwa Y AD - Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Japan. FAU - Kogo, Mari AU - Kogo M AD - Division of Pharmacotherapeutics, Department of Clinical Pharmacy, Showa University School of Pharmacy, Japan. LA - eng PT - Journal Article DEP - 20210615 PL - Japan TA - Intern Med JT - Internal medicine (Tokyo, Japan) JID - 9204241 RN - 0 (Antirheumatic Agents) RN - 9009-79-4 (Rheumatoid Factor) SB - IM MH - Aged MH - *Antirheumatic Agents/therapeutic use MH - *Arthritis, Rheumatoid/diagnosis/drug therapy MH - Blood Sedimentation MH - Female MH - Humans MH - Male MH - Retrospective Studies MH - Rheumatoid Factor MH - Treatment Outcome PMC - PMC8263196 OTO - NOTNLM OT - biological disease-modifying antirheumatic drugs OT - elderly OT - rheumatoid arthritis OT - scoring model COIS- The authors state that they have no Conflict of Interest (COI). EDAT- 2021/06/18 06:00 MHDA- 2021/06/22 06:00 PMCR- 2021/06/15 CRDT- 2021/06/17 05:54 PHST- 2021/06/17 05:54 [entrez] PHST- 2021/06/18 06:00 [pubmed] PHST- 2021/06/22 06:00 [medline] PHST- 2021/06/15 00:00 [pmc-release] AID - 10.2169/internalmedicine.6251-20 [doi] PST - ppublish SO - Intern Med. 2021;60(12):1827-1834. doi: 10.2169/internalmedicine.6251-20. Epub 2021 Jun 15.