Yıl: 2022 Cilt: 14 Sayı: 2 Sayfa Aralığı: 87 - 93 Metin Dili: İngilizce DOI: 10.4274/raed.galenos.2022.69188 İndeks Tarihi: 19-09-2022

Predicting the response to bDMARD treatment in RA: Then what?

Öz:
Objective: Biologic disease-modifying antirheumatic drugs (bDMARDs) offer promising results for rheumatoid arthritis (RA) patients in general, but a substantial percentage of patients do not respond to them. It is important to predict the response before the treatment so that unnecessary adversities for the patients and costs for the healthcare system can be avoided. This study aims to develop a machine learning (ML) model that works with readily-available demographic and clinical factors for prediction of response to bDMARDs, and discusses additional non-pharmacological practices. Methods: Several ML models were tested in 190 RA patients from Turkey, and the logistic regression model was found to be superior. The relation between long-term and short-term responses were also analyzed. Results: Predictors of the logistic regression model were age, sex, coronary artery disease, spine surgery, steroid treatment, sulfasalazine treatment and baseline health assesment questionnaire score. The model displayed 79.5% accuracy and an area under receiver operating characteristic curve of 0.82. 87% of the patients who were goodresponders in six-month follow-up were also good responders in oneyear follow-up. Among non-responders in six-month follow-up, 75% were also non-responders in one-year follow-up. Conclusion: Making the prediction at an early stage is crucial for the patients as well as the healthcare system. However, it is equally important to determine how to proceed with the patients who are unlikely to respond to bDMARDs. Current literature does not adequately answer this question. Additional treatment options and multiple evaluation criteria for these options should be considered; multiple criteria models can provide useful decision support for this purpose.
Anahtar Kelime:

Romatoid artritte bDMARD yanıtını öngörmek: Peki sonrasında?

Öz:
Amaç: Biyolojik hastalık modifiye edici antiromatizmal ilaçlar (bDMARD’lar) genel olarak romatoid artrit (RA) hastaları için umut verici sonuçlar sunar; ancak hastaların önemli bir yüzdesi bunlara yanıt vermez. Yan etkilerin azaltılması ve sağlık sistemi için maliyetlerden kaçınılabilmesi için yanıtın tedavi öncesi tahmin edilmesi önemlidir. Bu çalışmada, bDMARD’lara yanıtı tahmin etmek için demografik ve klinik faktörlerle çalışan bir makine öğrenimi (ML) modeli geliştirme ve ek farmakolojik olmayan uygulamaların tartışılması amaçlanmıştır. Yöntem: Yüz doksan Türk RA hastasında birkaç ML modeli test edilmiştir ve lojistik regresyon modelinin üstün olduğu bulunmuştur. Uzun ve kısa vadeli sonuçlar arasındaki ilişki de analiz edilmiştir. Bulgular: Lojistik regresyon modelinde, cinsiyet, koroner arter hastalığı, omurga cerrahisi, steroid tedavisi, sülfasalazin tedavisi ve başlangıç sağlık değerlendirme anketi skoru prediktör olarak saptanmıştır. Model, %79,5 doğruluk ve 0,82’lik bir alıcı işletim karakteristiği eğrisi altında kalan alan sergilemiştir. Altı aylık takipte iyi yanıt veren hastaların %87’sinin, bir yıllık takipte de iyi yanıt verdiği gözlemlenmiştir. Altı aylık takipte yanıt vermeyenlerin %75’inin bir yıllık takipte yanıt vermediği gözlemlenmiştir. Sonuç: Tedavi yanıtlarının erken aşamada öngörülmesi hastalar için olduğu kadar sağlık sistemi için de çok önemlidir. Bununla birlikte, bDMARD’lara yanıt verme olasılığı düşük olan hastalarda nasıl bir yol izleneceğini belirlemek de aynı derecede önemlidir. Mevcut literatür bu soruya yeterince cevap vermemektedir. Ek tedavi seçenekleri ve çoklu değerlendirme kriterleri göz önünde bulundurulmalıdır; çok kriterli modeller bu amaç için faydalı karar desteği sağlayabilir.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA Tuncer Sakar C, KARAKAYA G, Bilgin E, Kılıç L, Kalyoncu U (2022). Predicting the response to bDMARD treatment in RA: Then what?. , 87 - 93. 10.4274/raed.galenos.2022.69188
Chicago Tuncer Sakar Ceren,KARAKAYA GULSAH,Bilgin Emre,Kılıç Levent,Kalyoncu Umut Predicting the response to bDMARD treatment in RA: Then what?. (2022): 87 - 93. 10.4274/raed.galenos.2022.69188
MLA Tuncer Sakar Ceren,KARAKAYA GULSAH,Bilgin Emre,Kılıç Levent,Kalyoncu Umut Predicting the response to bDMARD treatment in RA: Then what?. , 2022, ss.87 - 93. 10.4274/raed.galenos.2022.69188
AMA Tuncer Sakar C,KARAKAYA G,Bilgin E,Kılıç L,Kalyoncu U Predicting the response to bDMARD treatment in RA: Then what?. . 2022; 87 - 93. 10.4274/raed.galenos.2022.69188
Vancouver Tuncer Sakar C,KARAKAYA G,Bilgin E,Kılıç L,Kalyoncu U Predicting the response to bDMARD treatment in RA: Then what?. . 2022; 87 - 93. 10.4274/raed.galenos.2022.69188
IEEE Tuncer Sakar C,KARAKAYA G,Bilgin E,Kılıç L,Kalyoncu U "Predicting the response to bDMARD treatment in RA: Then what?." , ss.87 - 93, 2022. 10.4274/raed.galenos.2022.69188
ISNAD Tuncer Sakar, Ceren vd. "Predicting the response to bDMARD treatment in RA: Then what?". (2022), 87-93. https://doi.org/10.4274/raed.galenos.2022.69188
APA Tuncer Sakar C, KARAKAYA G, Bilgin E, Kılıç L, Kalyoncu U (2022). Predicting the response to bDMARD treatment in RA: Then what?. Ulusal Romatoloji Dergisi, 14(2), 87 - 93. 10.4274/raed.galenos.2022.69188
Chicago Tuncer Sakar Ceren,KARAKAYA GULSAH,Bilgin Emre,Kılıç Levent,Kalyoncu Umut Predicting the response to bDMARD treatment in RA: Then what?. Ulusal Romatoloji Dergisi 14, no.2 (2022): 87 - 93. 10.4274/raed.galenos.2022.69188
MLA Tuncer Sakar Ceren,KARAKAYA GULSAH,Bilgin Emre,Kılıç Levent,Kalyoncu Umut Predicting the response to bDMARD treatment in RA: Then what?. Ulusal Romatoloji Dergisi, vol.14, no.2, 2022, ss.87 - 93. 10.4274/raed.galenos.2022.69188
AMA Tuncer Sakar C,KARAKAYA G,Bilgin E,Kılıç L,Kalyoncu U Predicting the response to bDMARD treatment in RA: Then what?. Ulusal Romatoloji Dergisi. 2022; 14(2): 87 - 93. 10.4274/raed.galenos.2022.69188
Vancouver Tuncer Sakar C,KARAKAYA G,Bilgin E,Kılıç L,Kalyoncu U Predicting the response to bDMARD treatment in RA: Then what?. Ulusal Romatoloji Dergisi. 2022; 14(2): 87 - 93. 10.4274/raed.galenos.2022.69188
IEEE Tuncer Sakar C,KARAKAYA G,Bilgin E,Kılıç L,Kalyoncu U "Predicting the response to bDMARD treatment in RA: Then what?." Ulusal Romatoloji Dergisi, 14, ss.87 - 93, 2022. 10.4274/raed.galenos.2022.69188
ISNAD Tuncer Sakar, Ceren vd. "Predicting the response to bDMARD treatment in RA: Then what?". Ulusal Romatoloji Dergisi 14/2 (2022), 87-93. https://doi.org/10.4274/raed.galenos.2022.69188