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Table 2 Overview of results on RORs for assessment of low disease activity and remission using the DAS 28, SDAI, CDAI and the Boolean approach (remission only), placebo-controlled studies

From: A systematic comparison of different composite measures (DAS 28, CDAI, SDAI, and Boolean approach) for determining treatment effects on low disease activity and remission in rheumatoid arthritis

Biologic versus placebo; in combination with MTX

Low disease activity, ROR (p value)

Remission, ROR (p value)

Number of studies

Number of patients

DAS 28 versus CDAI

DAS 28 versus SDAI

SDAI versus CDAI

Number of studies

Number of patients

DAS 28 versus CDAI

DAS 28 versus SDAI

SDAI versus CDAI

DAS 28 versus Boolean approach

SDAI versus Boolean approach

CDAI versus Boolean approach

IL-6 inhibitor

Tocilizumab

9

3307

2.90 (< 0.001)

2.54 (< 0.001)

1.10 (< 0.001)

9

3272

2.86 (< 0.001)

2.70 (< 0.001)

1.06 (0.240)

2.63 (< 0.001)

1.05 (0.648)

1.01 (0.953)

TNFα inhibitor

Adalimumab

12

4520

1.10 (0.045)

1.07 (0.142)

–*

13

4640

1.24 (0.019)

1.14 (0.139)

–*

1.02 (0.814)

0.89 (0.119)

0.82 (0.014)

Certolizumab pegol

6

2445

1.01 (0.952)

1.03 (0.719)

0.98 (0.595)

6

2458

1.06 (0.670)

1.13 (0.377)

0.94 (0.160)

1.35 (0.033)

1.20 (0.069)

1.29 (0.020)

Etanercept

3†

877

0.96 (0.691)

0.97 (0.737)

1.00 (0.947)

3†

877

0.79 (0.284)

0.72 (0.136)

1.09 (0.241)

1.05 (0.825)

1.42 (0.044)

1.31 (0.137)

Golimumab

5

987

1.03 (0.777)

0.93 (0.495)

1.08 (0.035)

5

987

1.00 (0.994)

0.92 (0.700)

1.07 (0.436)

0.93 (0.803)

0.96 (0.833)

0.93 (0.764)

Infliximab

1‡

171

0.65 (0.181)

0.57 (0.083)

1.15 (0.244)

1‡

171

0.70 (0.696)

0.31 (0.338)

2.23 (0.172)

0.50 (0.606)

1.61 (0.678)

0.72 (0.770)

IL-1 receptor antagonist

Anakinra

2‡

1035

1.42 (0.012)

1.27 (0.080)

1.12 (0.017)

2‡

1035

3.40 (0.017)

2.82 (0.046)

1.20 (0.408)

0.65

(0.595)

0.23 (0.024)

0.20 (0.015)

T-cell activation inhibitor

Abatacept

8

2363

1.16 (0.051)

1.06 (0.416)

–*

8

2364

1.01 (0.953)

0.94 (0.687)

0.99 (0.859)

0.80

(0.279)

0.81 (0.205)

0.82 (0.227)

B-cell depleting agent

Rituximab

2§

528

1.38 (0.441)

1.37 (0.423)

1.01 (0.941)

2§

534

0.80 (0.744)

0.54 (0.436)

1.52 (0.416)

2.15

(0.164)

3.12 (0.112)

2.53 (0.121)

  1. The thresholds used for the assessments were: DAS 28 < 3.2, SDAI ≤ 11 and CDAI ≤ 10 for low disease activity, DAS 28 < 2.6, SDAI ≤ 3.3, CDAI ≤ 2.8 and Boolean approach (≤ 1 swollen joint, ≤ 1 tender joint, C-reactive protein ≤ 1 mg/dl and global assessment of disease activity by the patient ≤ 1 on a scale from 0 to 10) for remission. Statistically significant RORs are shown in bold font. 95% CIs are shown in Additional file 1: Tables 1 and 2
  2. CDAI clinical disease activity index; DAS 28 disease activity score 28; MTX methotrexate; RORs ratio of odds ratios; SDAI simplified disease activity index
  3. * Not interpretable due to relevant heterogeneity among studies and / or study pools (p < 0.05)
  4. † Includes only studies on MTX-naïve patients and patients after MTX failure
  5. ‡ Includes only studies on patients after MTX failure
  6. § Includes only studies on patients after biologic failure
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BMC Rheumatology

ISSN: 2520-1026

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