Switching between TNFα antagonists in rheumatoid arthritis: personal experience and review of the literature

Conti, Fabrizio; Spinelli, F.R.; Truglia, S.; Magrini, L.; Franco, Manuela Di; Ceccarelli, Fulvia; Valesini, Guido

doi:10.4081/reumatismo.2009.107

Cited by 20 publications

(23 citation statements)

References 22 publications

(14 reference statements)

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“…Although anti-TNF-alpha agents have similar clinical effi cacy and costs, they differ in the following aspects: molecular structure; pharmacokinetics; mechanism of action; potential to form autoantibodies, and human anti-chimeric (HACA) or human anti-human (HAHA) antibodies; induction of apoptosis; and posology. [1][2][3] Thus, switching from one anti-TNF-alpha agent to another might be a treatment option in patients experiencing loss of effi cacy or intolerance to the fi rst treatment. 1,2 This study aimed at assessing the clinical response, especially functional capacity, after switching from one anti-TNF-alpha agent to another in patients with active, long-standing RA, and who had failed to respond to DMARDs, including MTX.…”

Section: Introductionmentioning

confidence: 99%

Estratégia de troca entre agentes anti-TNF-alfa não melhora a capacidade funcional em pacientes com artrite reumatoide de longa evolução

Soares¹,

Neto²,

Luz³

et al. 2012

Rev. Bras. Reumatol.

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Objectives:To assess clinical response after switching between anti-tumor necrosis factor-alpha (anti-TNF-alpha) agents in patients with rheumatoid arthritis (RA). Patients and methods: This study included 99 patients diagnosed with RA (American College of Rheumatology, 1987), on anti-TNF-alpha therapy, to assess the therapeutic response after 24 weeks. Switching was performed if, after 12 to 24 weeks, a severe adverse event was reported (toxicity: T) or if no reduction greater than 0.6 in the initial Disease Activity Score 28 (DAS28) occurred (inadequate response: IR). In case of IR, the patient was considered as primary failure (PF). Secondary failure (SF) was defi ned as loss of response after initial improvement. Remission (DAS28 < 2.6), low disease activity (between 2.61 and 3.2), and functional improvement [increase in the initial Health Assessment Questionnaire (HAQ) > 0.2] were assessed by use of linear regression analysis. The signifi cance level adopted was P < 0.05. Results: Switching was performed in 39 (39.4%) patients, especially due to PF (24.3%), SF (35.1%) and T (40.5%). The retention rate of the fi rst agent was 60.1%, and the mean time for switching was 14.2 ± 10.9 months. After switching, a tendency towards a decrease in DAS28 was observed (4.7 ± 1.4; P = 0.08), but not in the HAQ (1.2 ± 0.77; P = 0.11). Around 43% of the patients achieved good/moderate EULAR response. The major determinant of switching was a higher initial DAS28, independent of age, duration of disease, and functional capacity. Conclusion: Switching between anti-TNF-alpha agents is a valid strategy to control disease activity, despite the low likelihood of remission and no signifi cant improvement in functional capacity.

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Section: Introductionmentioning

confidence: 99%

Estratégia de troca entre agentes anti-TNF-alfa não melhora a capacidade funcional em pacientes com artrite reumatoide de longa evolução

Soares¹,

Neto²,

Luz³

et al. 2012

Rev. Bras. Reumatol.

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“…Patients who do not respond to an initial anti-TNF drug may also improve their HAQ score, subsequent to switching to a second agent (65). Patients with RA may be successfully treated with another TNF-α agent, especially those withdrawing due to inefficacy and adverse events (66). The above results demonstrated that switching among various biological agents was beneficial.…”

Section: Switching Between Various Anti-tnf Agentsmentioning

confidence: 89%

TNF Inhibitor Therapy for Rheumatoid Arthritis

Ma¹,

Xu²

2012

J Clin Cell Immunol

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“…Однако если на второй ингибитор ФНО ␣ переключили «неот-ветчиков» на первый препарат этого же класса, то сила клинического эффекта была низкой. Среди пациентов, которые были переведены на второй ингибитор ФНО ␣ вследствие отсутствия ответа, недостаточного ответа или НЯ, средний/хороший ответ по критериям EULAR был зарегистрирован у 38,4; 66,6 и 88,8% пациентов, соот-ветственно [32]. Таким образом, при отсутствии ответа на первый ингибитор ФНО ␣ (группа «неответчиков») мож-но предположить существование общей резистентности к блокаторам ФНО ␣ и недостаточный ответ на второй анти-ФНО ␣-препарат.…”

Section: Discussionunclassified

Treatment with Genetically Engineered Biological Agents: Efficacy and Safety of Changeover

Baranov¹,

Alexeeva²,

Валиева³

et al. 2014

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ВВЕДЕНИЕЮвенильный идиопатический артрит (ЮИА) -поли-генное, мульфакториальное заболевание с очень слож-ным иммуноагрессивным патогенезом [1].До 1990 г. лечение ЮИА было основано на принци-пе пирамиды: его начинали с нестероидных противовос-палительных препаратов (НПВП) и глюкокортикоидов (ГК), к которым постепенно добавляли другие иммуно-депрессанты [2].За последние 15 лет подходы к терапии ЮИА изме-нились. Благодаря разработке нового класса препара-тов, обладающих способностью селективно блокиро-Терапия генно-инженерными биологическими препаратами: эффективность и безопасность переключения ( Вопросы современной педиатрии. 2014; 13 (1): 33-50)

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Switching between TNFα antagonists in rheumatoid arthritis: personal experience and review of the literature

Cited by 20 publications

References 22 publications

Estratégia de troca entre agentes anti-TNF-alfa não melhora a capacidade funcional em pacientes com artrite reumatoide de longa evolução

Estratégia de troca entre agentes anti-TNF-alfa não melhora a capacidade funcional em pacientes com artrite reumatoide de longa evolução

TNF Inhibitor Therapy for Rheumatoid Arthritis

Treatment with Genetically Engineered Biological Agents: Efficacy and Safety of Changeover

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