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Table 3 Predictors of sustained remission in induction-withdrawal studies and studies of discontinuation of maintenance tumor necrosis factor inhibitor (TNFi) treatment

From: Prevalence and predictors of sustained remission/low disease activity after discontinuation of induction or maintenance treatment with tumor necrosis factor inhibitors in rheumatoid arthritis: a systematic and scoping review

 

Induction-withdrawal studies

Maintenance discontinuation studies

Predictor

Number of studies

Effect size (SMD, OR, or HR)

P

I2

Number of studies

Effect size (SMD, OR, or HR)

P

I2

Older age, continuous, SMD

4

0.12 (− 0.56, 0.82)

0.72

71.6

11

 − 0.15 (− 0.34, 0.03)

0.10

0

Older age, categorical, OR

2

0.58 (0.37, 0.89)

0.01

0

1

0.85 (0.57, 1.25)

0.83

-

Older age, categorical, HR

1

1.00 (0.98, 1.02)

0.99

-

2

1.03 (0.91, 1.17)

0.62

0

Women vs Men, OR

5

0.75 (0.49, 1.15)

0.19

0

11

0.91 (0.67, 1.25)

0.57

0

Women vs Men, HR

1

0.91 (0.50, 1.66)

0.97

-

2

0.98 (0.82, 1.19)

0.84

0

Duration of RA, continuous, SMD

4

 − 0.40 (− 0.72, − 0.08)

0.02

4.9

11

 − 0.26 (− 0.45, − 0.07)

0.006

0

Duration of RA, categorical, OR

2

0.76 (0.44, 1.31)

0.32

50.5

2

0.35 (0.13, 0.91)

0.03

63.0

Duration of RA, categorical, HR

1

0.78 (0.69, 0.88)

 < 0.001

-

1

1.05 (0.74, 1.47)

0.77

-

Duration of TNFi treatment prior to discontinuation, continuous, SMD

2

 − 0.45 (− 0.91, 0.01)

0.06

0

5

0.06 (− 0.66, 0.79)

0.86

73.4

Duration of TNFi treatment prior to discontinuation, categorical, OR

0

-

-

-

2

1.22 (0.95, 1.57)

0.12

57.9

Duration of TNFi treatment prior to discontinuation, categorical, HR

1

0.54 (0.41, 0.78)

0.002

-

0

-

-

-

Length of remission at time of TNFi discontinuation, continuous, SMD

0

-

-

-

6

0.13 (− 0.31, 0.57)

0.56

53.6

Time to reach remission with TNFi, continuous, SMD

0

-

-

-

3

 − 0.36 (− 0.69, − 0.03)

0.03

0

Time to reach remission with TNFi, categorical, OR

1

4.66 (0.70, 31.03)

0.82

-

0

-

-

-

Time to reach remission with TNFi, categorical, HR

0

-

-

-

1

0.67 (0.47, 0.95)

0.03

-

Type of TNFi: Monoclonal antibody vs Etanercept, OR

0

-

-

-

6

1.64 (0.98, 2.74)

0.06

26.4

Methotrexate dose, continuous, SMD

2

 − 0.18 (− 0.57, 0.20)

0.34

0

9

0.05 (− 0.14, 0.25)

0.57

0

Methotrexate dose, categorical, OR

1

0.78 (0.46, 1.34)

0.37

-

0

-

-

-

Glucocorticoid use, categorical, OR

2

1.30 (0.11, 15.17)

0.84

69.4

7

0.93 (0.46, 1.91)

0.85

23.6

Glucocorticoid use, categorical, HR

0

-

-

-

1

0.56 (0.29, 1.08)

0.09

-

RF value, continuous, SMD

3

0.03 (− 0.55, 0.61)

0.91

54.2

2

0.19 (− 0.26, 0.65)

0.40

25.6

RF positive vs negative, OR

2

0.73 (0.45, 1.20)

0.21

0

10

0.75 (0.54, 1.03)

0.08

0

RF positive vs negative, HR

1

0.83 (0.41, 1.67)

0.62

-

0

-

-

-

ACPA titer, continuous, SMD

1

 − 0.27 (− 0.82, 0.27)

0.35

-

0

-

-

-

ACPA positive vs negative, OR

1

0.40 (0.11, 1.40)

0.16

-

9

0.86 (0.62, 1.20)

0.39

0

ACPA positive vs negative, HR

1

0.66 (0.34, 1.25)

0.22

-

0

-

-

-

HLA shared epitope present vs absent, HR

1

0.25 (0.09, 0.71)

0.008

-

0

-

-

-

Radiographic damage, Sharp Score continuous, SMD

1

 − 0.47 (− 1.02, 0.07)

0.11

-

3

 − 0.50 (− 0.82, − 0.17)

0.002

1.3

Radiographic damage, categorical, OR

2

1.25 (0.34, 4.59)

0.73

28.4

4

0.78 (0.66, 0.92)

0.004

2.3

Radiographic damage, categorical, HR

1

0.98 (0.96, 1.00)

0.05

-

0

-

-

-

BMI continuous, SMD

0

-

-

-

1

0.32 (− 0.09, 0.75)

0.14

-

BMI categorical, OR

0

-

-

-

2

0.71 (0.51, 0.99)

0.04

0

BMI categorical, HR

1

0.96 (0.89, 1.04)

0.69

-

1

0.80 (0.66, 0.96)

0.02

-

Smoker vs non-smoker, OR

0

-

-

-

1

0.63 (0.21, 1.88)

0.41

-

Smoker vs non-smoker, HR

1

0.41 (0.23, 0.71)

0.002

-

1

0.83 (0.70, 0.99)

0.04

-

HAQ continuous, SMD

4

 − 0.33 (− 0.67, 0)

0.05

12.1

7

0 (− 0.25, 0.24)

0.99

0

HAQ categorical, OR

1

0.98 (0.60, 1.60)

0.94

-

0

-

-

-

HAQ categorical, HR

1

0.66 (0.34, 1.25)

0.22

-

1

0.82 (0.69, 0.97)

0.03

-

Disease activity, continuous, SMD

4

 − 0.73 (− 1.30, − 0.16)

0.02

57.4

8

 − 0.21 (− 0.59, 0.16)

0.26

51.7

Disease activity, categorical, OR

2

0.70 (0.37, 1.32)

0.27

69.0

3

0.47 (0.16, 1.38)

0.17

83.0

Disease activity, categorical, HR

2

0.71 (0.45, 1.12)

0.14

59.6

2

0.76 (0.65, 0.88)

 < 0.01

0

MBDA > 44 vs ≤ 44, categorical, OR

1

0.08 (0.004, 1.67)

0.20

-

1

0.43 (0.24, 0.75)

0.003

-

Ultrasound Grey scale, continuous, SMD

1

 − 0.45 (− 1.34, 0.43)

0.25

-

4

 − 0.02 (− 0.36, 0.33)

0.93

0

Ultrasound power Doppler continuous, SMD

1

 − 0.08 (− 0.96, 0.80)

0.97

-

4

 − 0.30 (− 0.68, 0.07)

0.12

13.4

Ultrasound power Doppler categorical, HR

0

-

-

-

2

0.34 (0.09, 1.31)

0.12

70.1

  1. SMD standardized mean difference, OR odds ratio, HR hazard ratio, RA rheumatoid arthritis, RF rheumatoid factor, ACPA anti-citrullinated protein antibody, HLA human leukocyte antigen, BMI body mass index, HAQ Health Assessment Questionnaire, MBDA Multi-biomarker disease activity score