Efficacy in current practice of switching between anti-tumour necrosis factor- agents in spondyloarthropathies
Open Access
- 2 December 2010
- journal article
- research article
- Published by Oxford University Press (OUP) in Rheumatology
- Vol. 50 (4), 714-720
- https://doi.org/10.1093/rheumatology/keq377
Abstract
Objective. Anti-TNF-α agents are remarkably effective in the treatment of SpAs. However, 30% of patients withdraw from anti-TNF-α agents yearly because of inadequate efficacy or side effects. The objective of this study was to assess in current practice the response to a second and a third anti-TNF-α. Methods. Retrospectively, all records of patients who had received at least two anti-TNF-α agents have been studied. For axial forms, treatment was considered effective if 3 months after switching the patient had a favourable expert opinion or showed an improvement in BASDAI of at least 2 on a scale of 0–10 or an improvement of 50% (BASDAI 50). For peripheral forms, the treatment was considered effective if the patient had a favourable expert opinion or if a clinical improvement of >30% of the swollen and tender joint counts was established. The reasons for switching were: (i) primary non-responder; (ii) loss of efficacy; and (iii) occurrence of side effects. To identify response predictor factors bivariate analysis was performed. Results. Three hundred and seventy-seven patients under anti-TNF-α agents were treated and 99 patients had received at least two anti-TNF-α agents. Twenty-eight of these 99 patients had been treated with three anti-TNF-α agents. Following the failure of a first anti-TNF-α, the response to a second agent was satisfactory in 80.8%. Patients who had received a third anti-TNF-α following failure of the first two also showed a satisfactory response in 82.1%. The reason for switching from the first or second agent was not predictive of the response. Conclusion. In the event of failure or intolerance to anti-TNF-α in the treatment of SpAs, performing a first or second switch produces a satisfactory therapeutic response.This publication has 28 references indexed in Scilit:
- A systematic review and meta-analysis of efficacy and toxicity of disease modifying anti-rheumatic drugs and biological agents for psoriatic arthritisAnnals Of The Rheumatic Diseases, 2008
- Switching tumour necrosis factor antagonists in patients with ankylosing spondylitis and psoriatic arthritis: an observational study over a 5-year periodAnnals Of The Rheumatic Diseases, 2007
- Effectiveness of adalimumab for rheumatoid arthritis in patients with a history of TNF-antagonist therapy in clinical practiceRheumatology, 2007
- Update on anti-tumor necrosis factor therapy in the spondyloarthropathies including psoriatic arthritisCurrent Opinion in Rheumatology, 2006
- Lack of efficacy of a third tumour necrosis factor α antagonist after failure of a soluble receptor and a monoclonal antibodyRheumatology, 2006
- Adalimumab (Humira®) restores clinical response in patients with secondary loss of efficacy from infliximab (Remicade®) or etanercept (Enbrel®): results from the STURE registry at Karolinska University HospitalScandinavian Journal of Rheumatology, 2005
- Adalimumab for the treatment of patients with moderately to severely active psoriatic arthritis: Results of a double‐blind, randomized, placebo‐controlled trialArthritis & Rheumatism, 2005
- Etanercept treatment of psoriatic arthritis: Safety, efficacy, and effect on disease progressionArthritis & Rheumatism, 2004
- Why is the concept of spondyloarthropathies important?Best Practice & Research Clinical Rheumatology, 2002
- Evaluation of Diagnostic Criteria for Ankylosing SpondylitisArthritis & Rheumatism, 1984