PMID- 19633797
OWN - NLM
STAT- MEDLINE
DCOM- 20090917
LR  - 20220330
IS  - 0048-7449 (Print)
IS  - 0048-7449 (Linking)
VI  - 61
IP  - 2
DP  - 2009 Apr-Jun
TI  - Switching between TNFalpha antagonists in rheumatoid arthritis: personal 
      experience and review of the literature.
PG  - 107-17
AB  - OBJECTIVE: To evaluate the clinical response after switching to another TNFalpha 
      antagonist in patients with rheumatoid arthritis (RA) and provide a review of the 
      literature on this topic. METHODS: In this ongoing, longitudinal, observational 
      study we have prospectively collected data of patients starting biological 
      treatments since 2000. The present analysis is restricted to RA patients who 
      switched to another anti-TNFalpha due to lack of efficacy (LaE), loss of efficacy 
      (LoE), or adverse events (AEs) by the end of December 2007. Disease activity 
      score (ESR-based DAS28) was calculated and the clinical response (none, moderate, 
      good) was evaluated according to the European League Against Rheumatism (EULAR) 
      criteria. Clinical remission (DAS28 <2.6) and low disease activity (DAS28 </=3.2) 
      were also evaluated. RESULTS: A total of 692 anti-TNFalpha-naive patients has 
      been registered, of whom 395 with a diagnosis of RA. Thirtyseven RA patients 
      switched to another TNFalpha antagonist. Three months after switching, the 
      proportion of patients with remission, low disease activity, good and 
      moderate/good EULAR responses grew from 0%, 2.7%, 0%, and 5.4% (baseline before 
      switching) to 16.2%, 35.1%, 27%, and 62.2% (p<0.05, p<0.001, p<0.001, p<0.000001, 
      respectively). Of the patients who switched because of LaE, LoE, and AEs a 
      moderate/good EULAR response was achieved in 38.4%, 66.6%, and 88.8% of patients, 
      respectively. Mean treatment duration with the second anti-TNFalpha was 
      significantly longer in patients switching for LoE and AEs than in those 
      switching for LaE (p<0.05). CONCLUSIONS: The findings of this study suggest that 
      RA patients may be successfully treated with another TNFalpha antagonist, 
      especially those withdrawing for LoE or AEs.
FAU - Scrivo, R
AU  - Scrivo R
AD  - Dipartimento di Clinica e Terapia Medica, Sezione di Reumatologia, Sapienza 
      Universita di Roma, Policlinico Umberto I, 00161 Roma, Italia.
FAU - Conti, F
AU  - Conti F
FAU - Spinelli, F R
AU  - Spinelli FR
FAU - Truglia, S
AU  - Truglia S
FAU - Magrini, L
AU  - Magrini L
FAU - Di Franco, M
AU  - Di Franco M
FAU - Ceccarelli, F
AU  - Ceccarelli F
FAU - Valesini, G
AU  - Valesini G
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Review
PL  - Italy
TA  - Reumatismo
JT  - Reumatismo
JID - 0401302
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Biomarkers)
RN  - 0 (Immunoglobulin G)
RN  - 0 (Receptors, Tumor Necrosis Factor)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 9007-41-4 (C-Reactive Protein)
RN  - B72HH48FLU (Infliximab)
RN  - FYS6T7F842 (Adalimumab)
RN  - OP401G7OJC (Etanercept)
SB  - IM
MH  - Adalimumab
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Antibodies, Monoclonal/therapeutic use
MH  - Antibodies, Monoclonal, Humanized
MH  - Antirheumatic Agents/administration & dosage/*therapeutic use
MH  - Arthritis, Rheumatoid/blood/diagnosis/*drug therapy
MH  - Biomarkers/blood
MH  - Blood Sedimentation
MH  - C-Reactive Protein/metabolism
MH  - Disease Progression
MH  - Dose-Response Relationship, Drug
MH  - Drug Therapy, Combination
MH  - Etanercept
MH  - Female
MH  - Humans
MH  - Immunoglobulin G/therapeutic use
MH  - Infliximab
MH  - Male
MH  - Medical Records
MH  - Middle Aged
MH  - Prospective Studies
MH  - Quality of Life
MH  - Receptors, Tumor Necrosis Factor/therapeutic use
MH  - Severity of Illness Index
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
MH  - Tumor Necrosis Factor-alpha/*antagonists & inhibitors
RF  - 34
EDAT- 2009/07/28 09:00
MHDA- 2009/09/18 06:00
CRDT- 2009/07/28 09:00
PHST- 2009/07/28 09:00 [entrez]
PHST- 2009/07/28 09:00 [pubmed]
PHST- 2009/09/18 06:00 [medline]
AID - 10.4081/reumatismo.2009.107 [doi]
PST - ppublish
SO  - Reumatismo. 2009 Apr-Jun;61(2):107-17. doi: 10.4081/reumatismo.2009.107.