{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T08:34:03Z","timestamp":1768898043896,"version":"3.49.0"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,6,5]],"date-time":"2020-06-05T00:00:00Z","timestamp":1591315200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care & Research"],"published-print":{"date-parts":[[2020,7]]},"abstract":"Objective<\/jats:title>Biologic disease\u2010modifying antirheumatic drugs (bDMARD<\/jats:styled-content>s) used for rheumatoid arthritis (RA<\/jats:styled-content>) treatment have several mechanisms of action. Interleukin\u20106 inhibitors (IL<\/jats:styled-content>\u20106i) block the production of acute\u2010phase reactants (APR<\/jats:styled-content>s), which are some of the composite measures of disease activity. We undertook this study to examine the agreement between the European League Against Rheumatism (EULAR<\/jats:styled-content>) response based on the erythrocyte sedimentation rate (ESR<\/jats:styled-content>) or C\u2010reactive protein level, the Simplified Disease Activity Index 50% response measure (SDAI<\/jats:styled-content>50), and the Clinical Disease Activity Index 50% response measure (CDAI<\/jats:styled-content>50) in patients treated with IL<\/jats:styled-content>\u20106i and other bDMARD<\/jats:styled-content>s.<\/jats:p><\/jats:sec>Methods<\/jats:title>We enrolled 306 patients with RA<\/jats:styled-content> who started or switched bDMARD<\/jats:styled-content>s. Treatment response at 6 months was analyzed. Kappa statistics were used to evaluate the agreement between different response measures. The contribution of APR<\/jats:styled-content>s to improvement in disease activity scores was examined. The change of Health Assessment Questionnaire (HAQ<\/jats:styled-content>) score was analyzed in IL<\/jats:styled-content>\u20106i\u2013treated patients.<\/jats:p><\/jats:sec>Results<\/jats:title>Good agreement was achieved between response measures, with \u03ba >0.6 in patients treated with tumor necrosis factor inhibitors or cytotoxic T\u2010lymphocyte\u2013associated antigen 4 immunoglobulin fusion protein. In IL<\/jats:styled-content>\u20106i\u2013treated patients, the agreement was low between the EULAR<\/jats:styled-content> response (ESR<\/jats:styled-content>) and the SDAI<\/jats:styled-content>50 or the CDAI<\/jats:styled-content>50 (\u03ba = 0.43 and 0.37, respectively). Under IL<\/jats:styled-content>\u20106i treatment, APR<\/jats:styled-content> improvement accounted for 56.0% of total improvement of the Disease Activity Score in 28 joints (DAS<\/jats:styled-content>28) using the ESR. When discordance was found between the CDAI<\/jats:styled-content>50 and EULAR<\/jats:styled-content> response in IL<\/jats:styled-content>\u20106i\u2013treated patients, all patients were classified as EULAR<\/jats:styled-content>\u2010only responders; there was no HAQ<\/jats:styled-content> improvement in EULAR<\/jats:styled-content>\u2010only responders.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>EULAR<\/jats:styled-content> response criteria overestimate the response under IL<\/jats:styled-content>\u20106i treatment because the APR<\/jats:styled-content> improvement largely contributes to the DAS<\/jats:styled-content>28 improvement.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23914","type":"journal-article","created":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T17:37:30Z","timestamp":1557164250000},"page":"942-949","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Evaluation of Response Criteria in 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Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,6,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780380602"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780390105"},{"key":"e_1_2_7_4_1","first-page":"S14","article-title":"ACR remission criteria and response criteria","volume":"24","author":"Ranganath VK","year":"2006","journal-title":"Clin Exp 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