The University of Toledo Translation Journal of Medical Sciences 
Internal Medicine Abstract, Department of Medicine Research Symposium UTJMS 2023 May 5; 11(1):e1-e1 

Predictors of Remission in Rheumatoid Arthritis Patients 
Treated with Biologics: A Systematic Review and Meta-
Analysis 

Yasmin Khader, MD1*, A. Beran, MD1, S. Ghazaleh, MD2, S. Devis, MD1, N. 
Altorok, MD3 

1Division of , Department of Medicine, The University of Toledo, Toledo, OH 43614 
2Division of, Department of Medicine, The University of Toledo, Toledo, OH 43614 
3Division of, Department of Medicine, The University of Toledo, Toledo, OH 43614 

*Corresponding author: Yasmin.Khader@utoledo.edu

Published: 05 May 2023 

Introduction: Biologics have emerged as an effective treatment of rheumatoid arthritis (RA). However, 
there is a significant proportion of patients who fail to respond to biologics. Identifying the predictors 
that affect the response to biologics remains challenging. 

Methods: A comprehensive literature search of PubMed, Embase, and Web of Science databases was 
conducted through May 01, 2022. We included all studies that used a multivariate model to assess for 
the predictors of remission in RA patients treated with biologics. We calculated pooled odds ratios (OR) 
with 95% confidence intervals (CI) for risk factors reported in ≥3 studies using a random-effects model. 

Results: A total of 16,934 patients with RA who were treated with biologics were included in twenty-
one studies. Our study showed that old age (OR 0.98 (0.97, 0.99), P <0.00001), female gender (OR 0.66 
(0.56, 0.77), P <0.00001), smoking history (OR 0.86 (0.75, 0.99), P 0.04), obesity (OR 0.95 (0.91, 0.99), 
P 0.02), poor functional status (OR 0.62 (0.48, 1.27), P < 0.00001), high disease activity (OR 0.90 (0.85, 
0.96), P 0.0005), and elevated ESR (OR 0.99 (0.98, 1.00), P 0.009) were poor predictors of remission. 
While positive Anti-citrullinated Protein Antibodies (OR 2.52 (1.53, 4.12), P 0.0003) was associated 
with high remission rate. 

Conclusion: Old age, female gender, obesity, smoking history, poor functional status, high disease 
activity, and elevated ESR at the time of diagnosis have been associated with poor response to biologics. 
Our findings could help establish a risk stratification model for predicting the remission rate in RA 
patients receiving biologics. 

https://dx.doi.org/10.46570/utjms.vol11-2023-703 

https://dx.doi.org/10.46570/utjms.vol11-2023-703
mailto:Yasmin.Khader@utoledo.edu