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Development and validation of a prognostic multivariable model to predict insufficient clinical response to methotrexate in rheumatoid arthritis

Author

Listed:
  • Maurits C F J de Rotte
  • Saskia M F Pluijm
  • Pascal H P de Jong
  • Maja Bulatović Ćalasan
  • Nico M Wulffraat
  • Angelique E A M Weel
  • Jan Lindemans
  • J M W Hazes
  • Robert de Jonge

Abstract

Objective: The objective was to predict insufficient response to 3 months methotrexate (MTX) in DMARD naïve rheumatoid arthritis patients. Methods: A Multivariable logistic regression model of rheumatoid arthritis patients starting MTX was developed in a derivation cohort with 285 patients starting MTX in a clinical multicentre, stratified single-blinded trial, performed in seven secondary care clinics and a tertiary care clinic. The model was validated in a validation cohort with 102 patients starting MTX at a tertiary care clinic. Outcome was insufficient response (disease activity score (DAS)28 >3.2) after 3 months of MTX treatment. Clinical characteristics, lifestyle variables, genetic and metabolic biomarkers were determined at baseline in both cohorts. These variables were dichotomized and used to construct a multivariable prediction model with backward logistic regression analysis. Results: The prediction model for insufficient response in the derivation cohort, included: DAS28>5.1, Health Assessment Questionnaire>0.6, current smoking, BMI>25 kg/m2, ABCB1 rs1045642 genotype, ABCC3 rs4793665 genotype, and erythrocyte-folate

Suggested Citation

  • Maurits C F J de Rotte & Saskia M F Pluijm & Pascal H P de Jong & Maja Bulatović Ćalasan & Nico M Wulffraat & Angelique E A M Weel & Jan Lindemans & J M W Hazes & Robert de Jonge, 2018. "Development and validation of a prognostic multivariable model to predict insufficient clinical response to methotrexate in rheumatoid arthritis," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-15, December.
    • Handle: RePEc:plo:pone00:0208534
    DOI: 10.1371/journal.pone.0208534
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