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The reason for discontinuation of the first tumor necrosis factor (TNF) blocking agent does not influence the effect of a second TNF blocking agent in patients with rheumatoid arthritis
- Source :
- The Journal of Rheumatology, 36, 2171-7, The Journal of Rheumatology, 36, 10, pp. 2171-7, Rheumatology, 36(10), 2171-7. Oxford University Press
- Publication Year :
- 2009
-
Abstract
- Objective.To investigate whether the reason for discontinuation of the first tumor necrosis factor (TNF) blocking agent influences the effect of a second TNF blocking agent.Methods.Data were used from 2 Dutch registries including patients with rheumatoid arthritis (RA) treated with TNF blocking agents. Patients were divided into 3 groups based on reason for discontinuation of the first: nonresponse, loss of response, or adverse events. The primary outcome was the change from baseline of the disease activity (by DAS28) at 6 months, corrected for the baseline DAS28 score. Secondary outcomes were the change from baseline at 3 months, EULAR response rates, and the percentages of patients who reached a DAS28 score ≤ 3.2 at 3 and at 6 months.Results.In total, 49 patients who failed due to nonresponse, 75 due to loss of response, and 73 due to adverse events were included. At 6 months, the change of DAS28 score from baseline did not differ significantly between the groups (−0.6 to −1.3; p ≥ 0.173) and similar good and moderate response rates were found (12% to 18%, p ≥ 0.523, and 34% to 55%, p ≥ 0.078, respectively). The secondary outcomes were also comparable between the 3 groups.Conclusion.The results of our observational study suggest that a second TNF blocking agent may be effective after failure of the first, regardless of the reason for discontinuation of the first TNF blocking agent.
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Immunology
Antibodies, Monoclonal, Humanized
Gastroenterology
Auto-immunity, transplantation and immunotherapy [N4i 4]
Receptors, Tumor Necrosis Factor
Etanercept
Arthritis, Rheumatoid
Disability Evaluation
Rheumatology
Internal medicine
Immunopathology
medicine
Humans
Immunology and Allergy
Registries
Treatment Failure
METIS-265947
Adverse effect
skin and connective tissue diseases
Aged
Netherlands
Retrospective Studies
Autoimmune disease
Tumor Necrosis Factor-alpha
business.industry
Adalimumab
Antibodies, Monoclonal
Middle Aged
medicine.disease
Infliximab
Surgery
Discontinuation
Treatment Outcome
Cytokine
Withholding Treatment
Evaluation of complex medical interventions [NCEBP 2]
Antirheumatic Agents
Immunoglobulin G
Rheumatoid arthritis
Female
Tumor necrosis factor alpha
business
Subjects
Details
- ISSN :
- 0315162X and 14620324
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- The Journal of Rheumatology
- Accession number :
- edsair.doi.dedup.....74614bee0eea8d8f23ddc61a6220be4c