PMID- 24470077
OWN - NLM
STAT- MEDLINE
DCOM- 20140919
LR  - 20220331
IS  - 2151-4658 (Electronic)
IS  - 2151-464X (Linking)
VI  - 66
IP  - 8
DP  - 2014 Aug
TI  - Effectiveness and safety of infliximab in rheumatoid arthritis: analysis from a 
      Canadian multicenter prospective observational registry.
PG  - 1142-51
LID - 10.1002/acr.22290 [doi]
AB  - OBJECTIVE: To describe the profile of rheumatoid arthritis (RA) patients treated 
      with infliximab in Canadian routine care and to assess the real-world 
      effectiveness and safety of infliximab. METHODS: Biologics-naive RA patients from 
      the Biologic Treatment Registry Across Canada were stratified based on their 
      enrollment year. Effectiveness was assessed with the changes in 
      clinical/laboratory parameters and patient-reported outcomes and the achievement 
      of minimal disease activity and remission. Safety was assessed with the incidence 
      of treatment-emergent adverse events (AEs). RESULTS: Among 628 patients, 45.9%, 
      34.6%, and 19.6% were enrolled between 2002-2005, 2005-2008, and 2008-2011, 
      respectively. Patients recruited in more recent years had significantly lower 
      Disease Activity Score with a 28-joint count using the C-reactive protein level 
      (DAS28-CRP), Simplified Disease Activity Index (SDAI), Clinical Disease Activity 
      Index (CDAI), swollen joint count in 28 joints, tender joint count in 28 joints, 
      physician's global assessment of disease activity, patient's global assessment of 
      disease activity, Health Assessment Questionnaire disability index, pain, 
      erythrocyte sedimentation rate, and CRP level (P < 0.01 for all). Patient 
      management also changed with a trend to initiate infliximab after failure of 
      fewer disease-modifying antirheumatic drugs (DMARDs). Six-month treatment with 
      infliximab resulted in statistically significant and clinically important 
      improvements in all disease parameters examined, which were sustained over 36 
      months. The cumulative probability of achieving remission by 36 months, as 
      defined by the DAS28, SDAI, and CDAI, was 56.2 (95% confidence interval [95% CI] 
      47.8-64.8), 31.0 (95% CI 23.8-39.8), and 36.2 (95% CI 28.5-45.3), respectively, 
      which was significantly greater in patients with lower baseline disease activity. 
      The profile and incidence of AEs were comparable to data previously reported for 
      tumor necrosis factor alpha inhibitors. CONCLUSION: RA patient characteristics at 
      infliximab initiation changed over time toward lower disease activity. 
      Furthermore, a trend to treat patients with fewer DMARDs before initiation of 
      infliximab was observed. However, treatment with infliximab was effective in 
      significantly reducing disease activity independent of the treatment initiation 
      year.
CI  - Copyright (c) 2014 by the American College of Rheumatology.
FAU - Thorne, Carter
AU  - Thorne C
AD  - Southlake Regional Health Centre, Newmarket, and University of Toronto, Toronto, 
      Ontario, Canada.
FAU - Bensen, William G
AU  - Bensen WG
FAU - Choquette, Denis
AU  - Choquette D
FAU - Chow, Andrew
AU  - Chow A
FAU - Khraishi, Majed
AU  - Khraishi M
FAU - Atkins, Christopher J
AU  - Atkins CJ
FAU - Kelsall, John T
AU  - Kelsall JT
FAU - Lehman, Allen J
AU  - Lehman AJ
FAU - Shawi, May
AU  - Shawi M
FAU - Khalil, Hayssam
AU  - Khalil H
FAU - Nantel, Francois
AU  - Nantel F
FAU - Rampakakis, Emmanouil
AU  - Rampakakis E
FAU - Sampalis, John S
AU  - Sampalis JS
FAU - Otawa, Susan
AU  - Otawa S
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Arthritis Care Res (Hoboken)
JT  - Arthritis care & research
JID - 101518086
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antirheumatic Agents)
RN  - B72HH48FLU (Infliximab)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antibodies, Monoclonal/adverse effects/*therapeutic use
MH  - Antirheumatic Agents/adverse effects/*therapeutic use
MH  - Arthritis, Rheumatoid/*drug therapy
MH  - Canada
MH  - Female
MH  - Humans
MH  - Infliximab
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Registries
MH  - Treatment Outcome
EDAT- 2014/01/29 06:00
MHDA- 2014/09/23 06:00
CRDT- 2014/01/29 06:00
PHST- 2013/03/28 00:00 [received]
PHST- 2014/01/14 00:00 [accepted]
PHST- 2014/01/29 06:00 [entrez]
PHST- 2014/01/29 06:00 [pubmed]
PHST- 2014/09/23 06:00 [medline]
AID - 10.1002/acr.22290 [doi]
PST - ppublish
SO  - Arthritis Care Res (Hoboken). 2014 Aug;66(8):1142-51. doi: 10.1002/acr.22290.