Have you ever thought about what the numbers mean when they say 50% ACR20 at 6 months? This simply says 50% of the group had a 20% response at 6 months. It means half improved by 20%. The ACR improvement criteria includes ACR20, ACR50 and ACR70. Meaning, 20%, 50% and 70% improvement. Easily enough to understand.
I was reviewing a research paper on Orencia. I will be having my 8th infusion on Thursday. I was wondering if it was being effective enough and if I should keep taking it.
The article had a chart for clinical responses in controlled trials. I reviewed the column that said inadequate response to methotrexate (The reason for being on Orencia; I think my methotrexate response is 50%, but it is not enough for me.)
A response of ACR20
3 months 62%
6 months 68%
12 months 73%
This means that at 3 months 62% of the patients had a 20% improvement
This means that at 6 months 68% of the patients had a 20% improvement.
This means that at 12 months 73% of the patients had a 20% improvement.
Is a twenty percent improvement enough for you. If you are really bad, twenty percent might ease your symptoms enough to make them bearable.
Let’s look at the ACR50 response
3 months 32%
6 months 40%
12 months 48%
This means that at 3 months 32% of the patients had a 50% improvement.
This means that at 6 months 40% of the patients had a 50% improvement.
This means that at 12 months 48% of the patients had a 50% improvement.
Also notice that more people improved as time passed. So if you have not improved enough, maybe time and infusions might help you reach a point of comfort.
Let’s look at ACR70
3 months 13%
6 months 20%
12 months 29%
This means that at 3 months 13% of the patients had a 70% improvement.
This means that at 6 months 20% of the patients had a 70% improvement.
This means that at 12 months 29% of the patients had a 70% improvement.
The best of the scoring was a ACR70 of 14% for 6 months. This means that 14% of the patients were able to sustain a 70% improvement for 6 months.
When I understood this, I understood that Orencia is not a cure by any means. I did understand that it was helping me an additional 25% to my 50% methotrexate help. My life has improved. Still I have symptoms, but I am functioning better than I was.
So your decision includes determining where on the scale of improvement you are and is it helping you enough to make the infusions worthwhile.