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Table 4 Flares and bDMARD dose in simulation of prediction-aided treatment

From: Using real-world data to dynamically predict flares during tapering of biological DMARDs in rheumatoid arthritis: development, validation, and potential impact of prediction-aided decisions

 

DRESS routine care

Simulation (cutoff: 35%)

DRESS DGDO

Mean no. of flares (95% CI)

0.48 (0.24–0.72)

0.75 (0.54–0.96)

1.21 (0.99–1.43)

Decrease in flares compared to DRESS DGDO (95% CI)

0.73 (0.40–1.0)

0.46 (0.16–0.74)

–

Mean bDMARD dose (95% CI)

0.91 (0.86–0.96)

0.64 (0.61–0.68)

0.54 (0.50–0.58)

Increase in bDMARD dose compared to DRESS DGDO (95% CI)

0.37 (0.31–0.44)

0.10 (0.05–0.16)

–

Percentage of patients flaring (95% CI)

27% (15–40)

45% (36–54)

71% (63–79)

Increase in bDMARD dose per flare prevented vs. DRESS DGDOa (95% CI)

0.51 (0.44–0.59)

0.22 (0.15–0.32)

–

Number of extra flares per full bDMARD dose saved vs. routine careb (95% CI)

–

1.0 (0.3–1.8)

2.0 (1.4–2.6)

  1. bDMARD biological disease-modifying antirheumatic drug, DGDO disease activity-guided dose optimisation
  2. aThe difference in mean bDMARD dose divided by the difference in mean flares compared with DRESS [9] DGDO. This represents the increase in bDMARD dose that was needed to prevent a flare over 18 months for this tapering strategy
  3. bThe mean difference in the number of flares, divided by the mean difference in bDMARD dose, compared to routine care. This represents the number of extra flares that occurred for each full dose of bDMARD that is tapered compared to routine care over 18 monhts using this tapering strategy