LymeNet Flash: Three-year effectiveness of anti-TNF-alpha therapy in patients w/rheumatoid arthritis

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Posted by AliG (Member # 9734) on :

Anti-tumor necrosis factor-alpha therapy in the ordinary clinical setting: Three-year effectiveness in patients with rheumatoid arthritis

Abstract

Objectives

The aim was to estimate the proportion of patients with rheumatoid arthritis (RA) achieving low disease activity by anti-tumour necrosis factor-alpha (TNF-α) therapy in an ordinary clinical setting.

Methods

Thirty-three patients with active RA despite methotrexate treatment were included in an open phase IV study of infliximab in combination with methotrexate.

The mean age was 53 years (range 21-71) and mean disease duration 10.7 years (1-32). Treatment was changed in cases of insufficient response or intolerable adverse events.

Response status to infliximab was assessed according to the American College of Rheumatology (ACR 20).

Disease activity score (DAS28) was assessed at baseline and at weeks 26, 54, 80, 106 and 158. Low disease activity is defined as DAS28 ≤3.2.

Results

ACR20 response to infliximab was recorded in 73% and 33% of the patients at weeks 26 and 158, respectively. Infliximab was discontinued in 16 patients, 15 of whom started other anti-TNF-α therapy.

The baseline DAS28-score of 6.3 (95% CI 5.9-6.6) was significantly reduced after 26 weeks to 4.1 (95% CI 3.6-4.7) and was later nearly stable. Low DAS28 was achieved by 36% of the patients at week 26, and by 15-24% at later assessments.

Conclusions

RA disease activity was significantly reduced, but DAS28 ≤3.2 was recorded in only 1/4 of the assessments. Increasing this proportion should be subject to continuous quality improvement efforts.

Keywords: Anti-TNF-α therapy; Low disease activity; Quality improvement; DAS28
Anne Kvalvik Grimstvedta, , , Lefsaker Livb, Dyvik Siric and Johan Brun Gorgasb
aHaugesund Rheumatism Hospital, Karmsundsgaten 134, Post office box 2175, N-5504 Haugesund, Norway
bDepartment of Rheumatology, Haukeland University Hospital, Haukeland, Norway
cSection for Rheumatology, University of Bergen, Bergen, Norway
Received 31 December 2006; accepted 26 April 2007. Available online 9 August 2007.

Corresponding author. Tel.: +47 52 80 50 00; fax: +47 52 80 50 09.

Posted by mjo (Member # 7876) on :

Imfliximab is Remicade or Humira. Saw a Mayo paper noting an increased risk for cancer in people who take these drugs. A related drug, Enbrel, might also be a suspect but it was not tested/studied.

Posted by AliG (Member # 9734) on :

Thanks MJO. [Smile]

That's just lovely. [Roll Eyes]

Posted by EyeBob (Member # 12572) on :

The increase risk of cancer in Humira is because it specifically reduces TNF which, as it's name implies, helps to coordinate the expression of tumors.

Posted by lou (Member # 81) on :

There are also reports of activated TB in people taking this. Messing with the immune system is dangerous.