الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Rheumatoid arthritis (RA) is a chronic-systemic-inflammatory-autoimmune disease. It is characterized by persistent synovitis, and it is associated with pain, joint damage, disability, and poor quality of life. The primary target for treatment of RA is disease remission or LDA. According to DAS28(ESR) the disease activity cut-offs for remission is <2.6 and for LDA is between 2.6 and 3.2. The TNFi have emerged as an effective treatment of RA. Usually, they are the first biologic drugs employed for treatment of RA after failure of csDMARDs. They can cause serious side effects and are expensive. A proportion of patients do not improve despite therapy. It remains a challenge to predict which patients will respond. This study aimed to investigate early predictors of primary TNFi failure in RA patients. This will help to improve risk-benefit ratio and cost-effectiveness in individual patients as well as the population level. This study is a retrospective, record-based, descriptive study with analytic component. It was carried out at Physical Medicine, Rehabilitation and Rheumatology department, Mansoura University Hospital, Mansoura, Egypt. This study included records of 87 RA patients during the period (August 2021- August 2022) who were treated with TNFi for the first time after failure of csDMARDs. from this study it was shown that increased age, being smoker, earlier age at onset, presence of deformity and positive anti-CCP at baseline are statistically significant predictors of overall failure (odds ratios are 1.11, 32.3, 0.855, 8.5 and 6.48 respectively) in the studied cases, with the overall percent predicted 70.1% by the combination of the previous factors. While concomitant MTX intake increase the responder rate by 9.2%.