Patterns of Response to Different Treatment Strategies in Seropositive Rheumatoid Arthritis Patients in a Tertiary Hospital in South‐Western Saudi Arabia: A Retrospective Study

Figures & data

Table 1 Demographic Characteristics of Our Patients

Bio-Demographic Data	Frequency N = 288	Percentage
Age in years
21–30	15	5%
31–40	51	18%
41–50	62	22%
51–60	93	32%
61+	67	23%
Gender
Male	34	12%
Female	254	88%
Co-morbidities
None	126	43.8%
Diabetes mellitus	62	21.5%
Hypertension	72	25.0%
Hypothyroidism	37	12.8%
Osteoporosis	40	13.9%
Ischemic heart disease	17	5.9%
Lung diseases	14	4.8%
Infections (latent tuberculosis and hepatitis B virus)	26	9%
Disease duration in years
1–4	38	13%
5–9	126	44%
10–19	96	33%
20+	28	10%
CDAI at the time of presentation
Moderate	11	4%
High	277	96%
Presence of deformity
Yes	20	7%
No	268	93%

Abbreviation: CDAI, the clinical disease activity index.

Table 2 Medications Used to Treat Our Patients

Current csDMARD	Frequency	Percentage %
None	5	2
MTX	46	16
LEF	7	2
HCQ	39	14
MTX, HCQ	136	47
LEF, HCQ	36	12
SZZ, HCQ	19	7
Current bDMARD/ tsDMARD
Adalimumab	54	32
Etanercept	35	21
Abatacept	33	20
Infliximab	1	1
Tocilizumab	23	14
Rituximab	16	10
Tofacitinib	6	4
Duration on bDMARD/tsDMARD (years)
1	46	27
2	32	19
3	29	17
4	24	14
5	22	13
6+	15	9
Current dose of steroid
Not on steroid	149	52
2.5 mg	20	7
5 mg	102	35
7.5 mg	3	1
10 mg	14	5

Abbreviations: csDMARDs, conventional synthetic disease-modifying antirheumatic drugs; MTX, methotrexate; LEF, leflunomide; HCQ, hydroxychloroquine; SZZ, sulfasalazine; bDMARDs, biological disease-modifying antirheumatic drugs; tsDMARDs, targeted synthetic disease-modifying antirheumatic drugs.

Figure 1 Disease activity according to CDAI.

Table 3 Choice of Biologic Agents and JAK Inhibitors in Our Patients

	Biologically Naive N = 168		First-Time Switcher N = 42		Second-Time Switcher N = 10		Third-Time Switcher N = 2
	No.	%	No.	%	No.	%	No.	%
Adalimumab	70	42	2	5
Etanercept	38	23	6	14
Certolizumab	1	1
Infliximab	2	1
Abatacept	31	18	22	52	1	10
Tocilizumab	12	7	8	19	6	60	1	50
Rituximab	11	7	2	5	3	30
Tofacitinib	3	2	2	5			1	50

Table 4 Comparison Between Treatment Regimens According to Demographic Characteristics of the Patients

Factors	Treatment Regimen				P-value
	csDMARD		Non- csDMARD
	No	%	No	%
Age in years
21–30	3	20.0%	12	80.0%
31–40	25	49.0%	26	51.0%
41–50	24	38.7%	38	61.3%	0.337
51–60	38	40.9%	55	59.1%
61+	30	44.8%	37	55.2%
Gender
Male	17	50.0%	17	50.0%	0.294
Female	103	40.6%	151	59.4%
Presence of comorbidities
No	58	46.0%	68	54.0%	0.185
Yes	62	38.3%	100	61.7%
Presence of FMS
Yes	11	26.8%	30	73.2%	0.037*
No	109	44.1%	138	55.9%
CDAI at the time of presentation
Moderate	9	81.8%	2	18.2%	0.006*
High	111	40.1%	166	59.9%
Presence of deformity
Yes	8	40.0%	12	60.0%	0.875
No	112	41.8%	156	58.2%
Extraarticular lung manifestations
Yes	4	16.0%	21	84.0%	0.006*
No	116	44.1%	147	55.9%
Extraarticular Skin manifestations
Yes	0	0.0%	5	100.0%	0.057^
No	120	42.4%	163	57.6%
Associated Sjogren’s syndrome
Yes	2	33.3%	4	66.7%	0.676
No	118	41.8%	164	58.2%
Extraarticular hematological manifestations
Yes	16	33.3%	32	66.7%	0.200
No	104	43.3%	136	56.7%

Notes: P: Pearson. X² test. ^Exact probability test. *P < 0.05 (significant).

Abbreviations: csDMARDs, conventional synthetic disease-modifying antirheumatic drugs; FMS, fibromyalgia syndrome; CDAI, the clinical disease activity index.

Table 5 Current CDAI in Fibromyalgia Patients vs Non-Fibromyalgia Patients According to the Treatment Regimen

Current Therapy	Current (CDAI)	Presence of Fibromyalgia				P-value
		Yes		No
		No.	%	No.	%
csDMARDs	Remission	0	0.0%	60	55.0%	0.001*
	Low	4	36.4%	47	43.1%
	Moderate	7	63.6%	2	1.8%
Non-csDMARDs	Remission	2	6.7%	59	42.8%	0.001*
	Low	9	30.0%	74	53.6%
	Moderate	19	63.3%	5	3.6%

Notes: P: Exact probability test. *P < 0.05 (significant).

Abbreviations: csDMARDs, conventional synthetic disease-modifying antirheumatic drugs; CDAI, the clinical disease activity index.