The efficiency of biologic therapy in a group of patients with rheumatoid arthritis.
OBJECTIVE
The following study aims to evaluate the monotherapy with biologic agents: Infliximab (IFX), Etanercept (ETA), Adalimumab (ADA) and Rituximab (RTX) in patients diagnosed with rheumatoid arthritis (RA).


METHODS
To achieve these objectives, the database of "Dr. I. Cantacuzino" Clinical Hospital, Department of Internal Medicine and Rheumatology, was used. The study was retrospective and descriptive, covering 168 patients with RA, followed for 12 months, from January 2012 to January 2013. Admission criteria for the study were the following: patients diagnosed with RA according to ACR 1987/ EULAR 2010 criteria, disease activity score (DAS 28)> 5.1, positive inflammation tests, presence of RA refractory to classic remitting treatment administered at least 6 months prior to the initiation of biological therapy, on patients treated with RTX. They were considered non-responders after 6 months of treatment with anti tumor necrosis factor alpha (anti-TNF) and decided to switch agents with anti CD-20.


RESULTS
Comparing values between any two points in time (baseline - 6 months -12 months) for any type of therapy, there were significant decreases in the values of erythrocyte sedimentation rate (ESR), reactive C protein (CRP) and disease activity score (DAS 28). There were no significant differences between therapies regarding ESR at 6 months (p = 0.070, ANOVA) and 12 months (p = 0.375, Kruskal-Wallis), significant differences were regarding CRP at 6 and 12 months (p = 0.000, Kruskal-Wallis) and DAS 28 at 6 months (p = 0.000, Kruskal- Wallis) and 12 months (p = 0.018, Kruskal-Wallis).


CONCLUSIONS
All 4 therapies have proven efficient, prognostic markers decreasing gradually at 6 and 12 months.
"Dr. I. Cantacuzino" Clinical Hospital, Bucharest, Department of Internal Medicine and Rheumatology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
B I
BI
Gavrilă
"Dr. I. Cantacuzino" Clinical Hospital, Bucharest, Department of Internal Medicine and Rheumatology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
C
C
Ciofu
"Dr. I. Cantacuzino" Clinical Hospital, Bucharest, Department of Internal Medicine and Rheumatology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
V
V
Stoica
Department of Medical Informatics and Biostatistics, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
E
E
Panaitescu
D000068879:Adalimumab / Q000627:therapeutic use; D000328:Adult; D017677:Age Distribution; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000473:pathology; D001691:Biological Therapy; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D018450:Disease Progression; D000068800:Etanercept / Q000627:therapeutic use; D005260:Female; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D000069283:Rituximab / Q000627:therapeutic use
D018501:Antirheumatic Agents; D000069283:Rituximab; D002097:C-Reactive Protein; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept
biologic therapy; rheumatoid arthritis