Retrospective investigation of parameters effecting multiple biological or targeting agent treatment for treatment of romatoid arthritis

Rheumatoid arthritis, in which many factors play a role in its etiology, is a chronic, systemic, autoimmune disease that primarily targets synovial tissues. Because of being systemic disease rheumatoid arthtritis can be able to affect many organ systems and tissues. The worldwide incidence of rheumatid arthrtis is 0,5-1%. Turkey prevalence is around 0,5%. The mean age is 35-50 years; however, it can start at any age. It is more common in women. The goals of treatment are to improve patients' quality of life by reducing symptoms, preventing joint damage, and decreasing complications of the disease. Non-steroidal anti-inflammatory drugs and steroids are aimed at managing the symptoms of the disease and reducing inflammation, but the mainstays of treatment have been conventional synthetic disease-modifying anti-rheumatic drugs (DMARDs). DMARDs treatments can still be divided into conventional synthetic DMARDs, biological therapies, while still maintaining their development. The basis of biological treatment is targeted DMARDs (target synthetic DMARDs), Anti-TNF and Non-Anti-TNF biological DMARDs. Our study included 130 patients with rheumatoid arthritis who were treated with conventional DMARDs, single or multiple biological treatment regimens and were still underfollow-up with these treatments. Age, gender, body mass index, concomitant diabetes mellitus presence, smoking, rheumatoid arthritis disease diagnosis year, rheumatoid factor value, anti-CCP (anti-cyclic citrullinated peptide), sedimentation, C-reactive protein values, DAS28-ESR (disease activity score-sedimantation rate) disease score, precision number of joints, number of swollen joints in the diagnosis period were investigated. The treatment groups consisted of conventional synthetic DMARDs, single biological DMARDs or targeted biological DMARDs, multiple biological DMARDs and / or targeted synthetic DMARDs. Patients were divided into 3 groups according to the treatment types and it was investigated whether there were any variables that would affect the type of treatment. In addition, the reasons for discontinuation or replacement of conventional DMARDs treatment, visual analog scale value and the reasons for the replacement of biological treatments were investigated. As a result, there were differences in the variables among the specific treatment groups, but studies on the parameters that may affect the treatment process were insufficient in the literature.