title: Effects of adalimumab administration in bio-naïve and bio-switch rheumatoid arthritis patients in daily clinical practice : two-year results from single center.
abstract: OBJECTIVE
  To investigate the impact of adalimumab on the biologic-naive (bio-naïve) and bio-switch rheumatoid arthritis (RA) patients, and to clarify the appropriate indications for adalimumab treatment.
  
  
  METHODS
  The retention rate, efficacy and safety of adalimumab in twenty-one RA patients were analyzed. Fourteen of the patients were bio-naive and seven were bio-switched from other biologics. Concomitant methotrexate was used in 85% of the bio-naive and 71% of the bio-switch patients. The radiographic findings before and after the 1 year and the two years treatment were also surveyed.
  
  
  RESULTS
  In the bio-naive group, 63% of patients continued adalimumab for 2 years, and remission was achieved in approximately 50% of patients. The mean 28-joint Disease Activity Scores improved from 5.2 to 2.6. Radiographically, the joint damage did not progress in either erosions or joint space narrowing. In the bio-switch group, the retention rate was 29%, and only patients who were switched from infliximab showed responses to the treatment. Herpes zoster requiring hospitalization occurred in two cases and injection site reactions were noted in other two cases.
  
  
  CONCLUSIONS
  Adalimumab combined with methotrexate would be a useful first choice biologic regimen in bio-naïve RA patients. As a second biologic, adalimumab could be useful only when treatments are switched from infliximab.
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Tashiro
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Nakashima
authors.forename: Ken
authors.initials: K
authors.lastname: Okazaki
authors.forename: Taro
authors.initials: T
authors.lastname: Mawatari
authors.forename: Jun-Ichi
authors.initials: J
authors.lastname: Fukushi
authors.forename: Masanobu
authors.initials: M
authors.lastname: Ohishi
authors.forename: Akiko
authors.initials: A
authors.lastname: Oyamada
authors.forename: Hisakata
authors.initials: H
authors.lastname: Yamada
authors.forename: Yukihide
authors.initials: Y
authors.lastname: Iwamoto
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D018501:Antirheumatic Agents / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy*; D001175:Arthrography; D057915:Drug Substitution; D004359:Drug Therapy, Combination; D006801:Humans; D000069285:Infliximab; D007279:Injections, Subcutaneous; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D012074:Remission Induction; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D000069285:Infliximab; D000068879:Adalimumab; D008727:Methotrexate