Efficacy and safety of switching from infliximab to adalimumab: a comparative controlled study.
OBJECTIVE
To describe the efficacy and safety of adalimumab in patients with rheumatoid arthritis (RA) who had previously discontinued infliximab treatment.


METHODS
24 patients with RA who discontinued treatment with infliximab (switchers) were treated with adalimumab (40 mg every 2 weeks, subcutaneously) for 12 months. The results were compared with those for 25 patients with RA receiving adalimumab who had not previously used an anti-tumour necrosis factor alpha inhibitor (controls). Disease activity was measured with the 28 joint count Disease Activity Score (DAS28), and clinical response with the American College of Rheumatology (ACR) 20% response criteria.


RESULTS
At baseline there were no differences in demographic, clinical, and laboratory features between the two groups. After 12 months' adalimumab treatment, clinical improvement was similar in both groups. More specifically, ACR 20% response criteria were achieved by 18/24 (75%) switchers and by 19/25 (76%) subjects in the control group. Four switchers discontinued the study-two because of adverse events and two because of lack of efficacy, while three control patients discontinued the study-one because of lack of efficacy and two owing to side effects.


CONCLUSIONS
Adalimumab is a well tolerated and effective treatment for patients with RA, even when infliximab has been discontinued.
Nikas
S N
SN
Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, 45110 Ioannina, Greece.
Voulgari
P V
PV
Alamanos
Y
Y
Papadopoulos
C G
CG
Venetsanopoulou
A I
AI
Georgiadis
A N
AN
Drosos
A A
AA
D000068879:Adalimumab; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D004334:Drug Administration Schedule; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D000069285:Infliximab; D007596:Joints / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D000069285:Infliximab; D000068879:Adalimumab