Anti-TNFalpha therapy in a cohort of rheumatoid arthritis patients: clinical outcomes.
OBJECTIVE
To assess the effectiveness of anti-TNFalpha agents by analysing the principal clinical outcomes in patients with active rheumatoid arthritis (RA).


METHODS
1010 patients who received no clinical benefit from previous treatment with methotrexate and/or other DMARDs, were subsequently treated with one or more of the anti-TNFalpha agents.


RESULTS
After the first six months of anti-TNFalpha therapy, 29% of the patients showed a good and 47% a moderate European League Against Rheumatism (EULAR) response, and this positive result was maintained after two years of follow-up. Their median Disease Activity Score based on the erythrocyte sedimentation rate and the evaluation of 28 joints (DAS28) decreased from 5.94 at baseline to 4 after six months (p<0.001; Delta 1.94), and further significant responses were also observed after 12, 18 and 24 months; their median 36-month DAS28 score reflected mild disease activity. The median Health Assessment Questionnaire (HAQ) score fell from 1.34 at baseline to 1 after six months of therapy (Delta 0.34; p<0.05), and a further significant reduction was observed during the second and third year of follow up.


CONCLUSIONS
Especially when combined with DMARDs, anti-TNFalpha drugs can induce a good clinical response regardless of the particular molecule used, whereas their combination with steroids does not seem to improve disease outcomes at any time during follow-up.
Bazzani
Chiara
C
Rheumatology and Immunology Unit, Spedali Civili di Brescia, Brescia, Italy. bazzani@bresciareumatologia.it
Filippini
Matteo
M
Caporali
Roberto
R
Bobbio-Pallavicini
Francesca
F
Favalli
Ennio Giulio
EG
Marchesoni
Antonio
A
Atzeni
Fabiola
F
Sarzi-Puttini
Piercarlo
P
Gorla
Roberto
R
D000068879:Adalimumab; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid / Q000276:immunology / Q000628:therapy*; D015331:Cohort Studies; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D000068800:Etanercept; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage*; D016233:Immunotherapy, Active; D000069285:Infliximab; D007262:Infusions, Intravenous; D007279:Injections, Subcutaneous; D007558:Italy; D008297:Male; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*
D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept