Switching TNF-alpha antagonists in rheumatoid arthritis: the experience of the LORHEN registry.
New biologic agents have changed the paradigm of rheumatoid arthritis treatment, leading to improvement in managing patients' refractory to classical DMARDs. Anti-TNF-alpha is used as first-line treatment in patients failing to respond to classical DMARDs. However, up to 50% of patients fail to respond to these drugs or develop adverse events leading to treatment discontinuation: in these cases the optimal treatment strategy is still a matter of debate even if trying with a second anti-TNF-alpha is considered a good option. We report data of patients switching from a first to a second anti-TNF-alpha from an Italian registry of patients with rheumatoid arthritis, showing that switching is valuable in patients stopping a first anti-TNFalpha drug. The patients with higher disease activity levels and those stopping the first anti-TNFalpha treatment because of a lack of efficacy are very likely to respond to the second treatment.
Caporali
Roberto
R
Division of Rheumatology, University of Pavia, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. caporali@smatteo.pv.it
Sarzi-Puttini
Piercarlo
P
Atzeni
Fabiola
F
Gorla
Roberto
R
Filippini
Matteo
M
Marchesoni
Antonio
A
Favalli
Ennio Giulio
EG
Bobbio-Pallavicini
Francesca
F
Montecucco
Carlomaurizio
C
D000068879:Adalimumab; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D001172:Arthritis, Rheumatoid / Q000276:immunology* / Q000503:physiopathology / Q000628:therapy*; D018450:Disease Progression; D000068800:Etanercept; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D007167:Immunotherapy; D000069285:Infliximab; D007558:Italy; D008297:Male; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012042:Registries; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept