PMID- 21062852 OWN - NLM STAT- MEDLINE DCOM- 20110318 LR - 20220330 IS - 1468-2060 (Electronic) IS - 0003-4967 (Linking) VI - 70 IP - 1 DP - 2011 Jan TI - Effectiveness of switching between TNF inhibitors in ankylosing spondylitis: data from the NOR-DMARD register. PG - 157-63 LID - 10.1136/ard.2010.131797 [doi] AB - OBJECTIVE: To assess the effectiveness of switching to a second tumour necrosis factor inhibitor (TNFi) in patients with ankylosing spondylitis (AS). METHODS: Data were extracted from an ongoing longitudinal observational multicentre study in Norway. This study included anti-TNF naive patients with AS starting treatment with a TNFi as well as treatment with a second TNFi in these same patients. Effectiveness data and 2-year drug survival were compared between switchers and non-switchers and within switchers (first and second TNFi). RESULTS: 514 anti-TNF naive patients with AS were included; 77 patients switched to a second TNFi while 437 patients did not switch. The percentages of non-switchers using etanercept, infliximab or adalimumab were 53%, 32% and 15%, and the percentages of first and second TNFi in the switchers were 42%, 53% and 5% and 40%, 23% and 36%, respectively. The reason for switching was insufficient response (IR) in 30, adverse events (AEs) in 44 and not reported in 3 patients. Baseline disease activity was similar between the groups. Three-month BASDAI 50 and ASAS 40 responses were achieved by 49% and 38% of non-switchers, by 25% and 30% of switchers after the first TNFi and by 28% and 31% after the second TNFi. The 3-month disease activity level was higher for switchers on the second TNFi than for non-switchers. Drug withdrawal rate was higher during the second TNFi among switchers than for non-switchers (p=0.001). No difference was found in the effectiveness of the second TNFi between switchers due to IR and AE. CONCLUSION: This study confirms that switching to a second TNFi can be effective in AS and can be as useful as in rheumatoid arthritis, although overall effectiveness seems to be somewhat lower than in non-switchers. FAU - Lie, E AU - Lie E AD - Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. elisabeth_lie@yahoo.no FAU - van der Heijde, D AU - van der Heijde D FAU - Uhlig, T AU - Uhlig T FAU - Mikkelsen, K AU - Mikkelsen K FAU - Rodevand, E AU - Rodevand E FAU - Koldingsnes, W AU - Koldingsnes W FAU - Kaufmann, C AU - Kaufmann C FAU - Kvien, T K AU - Kvien TK LA - eng PT - Clinical Trial PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20101109 PL - England TA - Ann Rheum Dis JT - Annals of the rheumatic diseases JID - 0372355 RN - 0 (Antibodies, Monoclonal) RN - 0 (Antibodies, Monoclonal, Humanized) RN - 0 (Antirheumatic Agents) RN - 0 (Immunoglobulin G) RN - 0 (Receptors, Tumor Necrosis Factor) RN - 0 (Tumor Necrosis Factor-alpha) RN - B72HH48FLU (Infliximab) RN - FYS6T7F842 (Adalimumab) RN - OP401G7OJC (Etanercept) SB - IM MH - Adalimumab MH - Adult MH - Antibodies, Monoclonal/adverse effects/therapeutic use MH - Antibodies, Monoclonal, Humanized MH - Antirheumatic Agents/adverse effects/*therapeutic use MH - *Drug Substitution MH - Epidemiologic Methods MH - Etanercept MH - Female MH - Humans MH - Immunoglobulin G/adverse effects/therapeutic use MH - Infliximab MH - Male MH - Middle Aged MH - Receptors, Tumor Necrosis Factor/therapeutic use MH - Spondylitis, Ankylosing/*drug therapy MH - Treatment Failure MH - Treatment Outcome MH - Tumor Necrosis Factor-alpha/*antagonists & inhibitors EDAT- 2010/11/11 06:00 MHDA- 2011/03/19 06:00 CRDT- 2010/11/11 06:00 PHST- 2010/11/11 06:00 [entrez] PHST- 2010/11/11 06:00 [pubmed] PHST- 2011/03/19 06:00 [medline] AID - ard.2010.131797 [pii] AID - 10.1136/ard.2010.131797 [doi] PST - ppublish SO - Ann Rheum Dis. 2011 Jan;70(1):157-63. doi: 10.1136/ard.2010.131797. Epub 2010 Nov 9.