Comparative effectiveness and predictors of response to tumour necrosis factor inhibitor therapies in rheumatoid arthritis

Canhão, Helena; Rodrigues, Ana Maria; Mourão, Ana Filipa; Martins, Fernando; Santos, Maria José; Canas-Silva, J.; Polido-Pereira, Joaquim; Silva, José Alberto Pereira; Costa, José António; Araújo, Domingos; Silva, Cândida; Santos, Helena; Duarte, Cátia; Silva, Jose António Pereira da; Pimentel-Santos, Fernando; Branco, Jaime; Karlson, Elizabeth W.; Fonseca, João Eurico; Solomon, Daniel H.

doi:10.1093/rheumatology/kes184

Cited by 88 publications

(68 citation statements)

References 17 publications

(7 reference statements)

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“…Observational studies have reported similar effectiveness at 24 weeks to that seen in our study for etanercept [30], and similar CDAI remission (18%) to our study when patients with RA were treated with adalimumab or etanercept for 12 months [31][32][33]. However, other studies have documented greater remission as measured by the CDAI for treatment with etanercept (35%) at 3 years and for adalimumab (27%) at 12 weeks [29,34].…”

Section: Discussionsupporting

confidence: 85%

Comparative effectiveness of adalimumab and etanercept for rheumatoid arthritis in the Brazilian Public Health System

et al. 2016

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Aim: Biological disease-modifying antirheumatic drugs (bDMARDs) are used to treat rheumatoid arthritis (RA) with adalimumab and etanercept the most used bDMARDs in Brazil. This open prospective cohort study evaluated their effectiveness and safety among RA patients in the Brazilian Public Health System given their costs. Methods: The Clinical Disease Activity Index was primarily used to assess their effectiveness after 6 and 12 months of follow-up. The Health Assessment Questionnaire and EuroQol-5D were also used. Results: A total of 266 RA patients started treatment with adalimumab or etanercept. Adalimumab was the most widely used bDMARD (70%). In total, 46% achieved remission or low-disease activity at 12 months with no difference in effectiveness between them (p = 0.306). bDMARDs were more effective in patients who had better functionality at treatment onset and had spent longer in education. Conclusion: This real-world study demonstrated that adalimumab and etanercept are equal alternatives for RA treatment and both were well tolerated.

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Section: Discussionsupporting

confidence: 85%

Comparative effectiveness of adalimumab and etanercept for rheumatoid arthritis in the Brazilian Public Health System

et al. 2016

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“…A majority of studies classified smoker or non-smoker by smoking status at the time of drug initiation, but some studies considered ex-smoking status. [7,8,[10][11][12] Some studies defined the amount of smoking as more than 5 cigarettes per day within 6 months from initiation of drug administration, [16,19,20,28,29] more than 7 cigarettes per week, [18,26] more than 1 cigarette per day, [17] or the presence of smoking without considering cigarette numbers. [13][14][15][22][23][24][25]27,[31][32][33][34] These variable smoking definitions could contribute to the discrepancy in the study results.…”

Section: Discussionmentioning

confidence: 99%

“…A total of 28 articles were finally selected. Among them, 6 articles were for RA [7][8][9][10][11][12] and 22 articles were for CD. Figure 1 shows the literature selection flows.…”

Section: Literature Selectionmentioning

confidence: 99%

“…They were all observational studies and reported outcomes using [7,9,10,12] without the other two articles (Canhao and Saevarsdottir) [8,11] categorizing outcomes as good responders and non-responders. Results of meta-analyses based on the smoking status and outcome presentation methods (i.e., ORs or percentage) are shown in Fig.…”

Section: Impact Of Smoking On Drug Response In Patients With Ramentioning

confidence: 99%

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Impact of smoking on the effectiveness of TNF-α inhibitors in patients with rheumatoid arthritis or Crohn's disease

Song

Sohn

Kim

et al. 2014

Transl Clin Pharmacol

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These authors contributed equally as co-first authorsCigarette smoking may be associated with the augmentation of pro-inflammatory cytokines including Tumor Necrosis Factor-alpha (TNF-α), which may affect the outcomes of pharmacological agents such as TNF-α inhibitors. The purpose of this study was to investigate the impact of smoking on the effectiveness of TNF-α inhibitors in patients with rheumatoid arthritis (RA) or Crohn's disease (CD). We used systematic literature review methods. A total of 1,147 articles were selected after exclusion of duplicates through a database search. Among them, 28 articles were finally selected through a review of titles and abstracts and a subsequent review of full articles. The effectiveness of TNF-α inhibitors in patients with RA or CD among the selected articles was summarized by their smoking status. Meta-analysis was performed with random effect model. When current smokers were compared with non-smokers for response after adjustments through meta-analysis among patients with RA, current smokers had 59% less response than non-smokers with statistical significance (Pooled adjusted OR=0.41, 95% CI=0.17-0.95). In patients with CD, current smokers tended to have lower clinical response than non-smokers, but statistical significance was not shown. In subgroup analyses for luminar CD or fistulizing CD, current smokers tended to have a lower response in luminar CD (Pooled OR=0.62, 95% CI=0.34-1.14), but smoking status was not associated with drug response in fistulizing CD. This study raises awareness of the adverse effects of smoking in terms of clinical response in patients treated with TNF-α inhibitors.

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“…This is reinforced by the therapeutic efficacy of rituximab, an anti-CD20 monoclonal antibody that specifically depletes B cells [7]. Other biologic treatments such as tumor necrosis factor (TNF) antagonists and the interleukin (IL)-6 receptor blocking antibody, tocilizumab, have also proven to be clinically effective in RA [8,9] by interfering with specific cytokine dependent mechanisms. In addition, both TNF and IL-6 can have B cell regulatory effects.…”

Section: Introductionmentioning

confidence: 99%

01.06 B-cell phenotype and igd-cd27- memory b cells are affected by tnf-inhibitors and tocilizumab treatment in rheumatoid arthritis

Moura

Quaresma

Vieira

et al. 2017

Crossroads in Innate and Adaptive Immunity

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Comparative effectiveness and predictors of response to tumour necrosis factor inhibitor therapies in rheumatoid arthritis

Abstract: Over 1 year, we found no difference in effectiveness between adalimumab, etanercept and infliximab.

Cited by 88 publications

References 17 publications

Comparative effectiveness of adalimumab and etanercept for rheumatoid arthritis in the Brazilian Public Health System

Comparative effectiveness of adalimumab and etanercept for rheumatoid arthritis in the Brazilian Public Health System

Impact of smoking on the effectiveness of TNF-α inhibitors in patients with rheumatoid arthritis or Crohn's disease

01.06 B-cell phenotype and igd-cd27- memory b cells are affected by tnf-inhibitors and tocilizumab treatment in rheumatoid arthritis

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