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.
-------------------- Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner. Posts: 4881 | From Middlesex County, NJ | Registered: Jul 2006
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posted
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.
Posts: 422 | From Luck home | Registered: Sep 2005
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AliG
Frequent Contributor (1K+ posts)
Member # 9734
posted
Thanks MJO. That's just lovely.
-------------------- Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner. Posts: 4881 | From Middlesex County, NJ | Registered: Jul 2006
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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.
Posts: 299 | From New Hampshire | Registered: Jul 2007
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There are also reports of activated TB in people taking this. Messing with the immune system is dangerous.
Posts: 8430 | From Not available | Registered: Oct 2000
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