{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T05:16:36Z","timestamp":1778217396530,"version":"3.51.4"},"reference-count":31,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,8,23]],"date-time":"2018-08-23T00:00:00Z","timestamp":1534982400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To assess the impact of baseline modified Rheumatic Disease Comorbidity Index (<jats:styled-content style=\"fixed-case\"><jats:italic>m<\/jats:italic>RDCI<\/jats:styled-content>) a simple comorbidity count, on overall survival of treatments with biological drugs in patients affected with Rheumatoid Arthritis (<jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>), Spondyloarthritis (SpA) and Psoriatic Arthritis (PsA) in real\u2010world settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients (nr. 635) with <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> (nr. 214), SpA (nr. 213) and PsA (nr. 208) starting a first biological drug were retrospectively analysed. <jats:styled-content style=\"fixed-case\">mRDCI<\/jats:styled-content> was scored at baseline, and disease characteristics were recorded at entry and at last observation. Drug retention was analysed using Kaplan\u2010Meier curves. Cox regression models were used to estimate the association of baseline <jats:styled-content style=\"fixed-case\">mRDCI<\/jats:styled-content> with drug discontinuation and clinical outcomes, the achievement of clinical remission based on 28 joint\u2010Disease Activity Score (<jats:styled-content style=\"fixed-case\">DAS<\/jats:styled-content>28) &lt;2.6 for <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> and PsA, and on Ankylosing Spondylitis\u2010C\u2010reactive protein Disease Activity Score (<jats:styled-content style=\"fixed-case\">ASDAS<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>) &lt;1.3 for SpA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline <jats:styled-content style=\"fixed-case\">mRDCI<\/jats:styled-content> significantly correlated with the number of biological drug switches (<jats:italic>rho<\/jats:italic> 0.26). Persistence on biologic therapy was significantly higher in patients with <jats:styled-content style=\"fixed-case\">mRDCI<\/jats:styled-content>=0 (96.4%), than in those with <jats:styled-content style=\"fixed-case\">mRDCI<\/jats:styled-content> \u22652 (83.9%). Patients without comorbidities showed significantly higher drug survival rate in PsA (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.0001) or SpA (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.02), but not in <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">mRDCI<\/jats:styled-content> was also found to be a predictor of definitive drug discontinuation (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>: 1.53) and of failure to achieve remission in <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>: 0.66) or PsA (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>: 0.77), and in SpA (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>: 0.43).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study provided evidence that baseline <jats:styled-content style=\"fixed-case\"><jats:italic>m<\/jats:italic>RDCI<\/jats:styled-content> negatively impacts the persistence on biologic treatments and clinical outcomes in patients with <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>, SpA and PsA in real\u2010life settings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.13013","type":"journal-article","created":{"date-parts":[[2018,8,7]],"date-time":"2018-08-07T07:40:23Z","timestamp":1533627623000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Influence of baseline modified Rheumatic Disease Comorbidity Index (<scp>mRDCI<\/scp>) on drug survival and effectiveness of biological treatment in patients affected with Rheumatoid arthritis, Spondyloarthritis and Psoriatic arthritis in real\u2010world 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