Real-world effectiveness of anti-TNF switching in psoriatic arthritis: a systematic review of the literature
| Autor: | Meghan D. Burns, Amber L. Martin, Jacqueline B. Palmer, Sheila Crean, Soumya M. Reddy |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Multivariate analysis Denmark Population MEDLINE Antibodies Monoclonal Humanized Receptors Tumor Necrosis Factor 03 medical and health sciences Psoriatic arthritis 0302 clinical medicine Rheumatology Refractory Internal medicine Odds Ratio medicine Humans Registries 030212 general & internal medicine education 030203 arthritis & rheumatology Biological Products education.field_of_study Drug Substitution Tumor Necrosis Factor-alpha business.industry Arthritis Psoriatic General Medicine Odds ratio medicine.disease Treatment Outcome Systematic review Antirheumatic Agents Immunoglobulin G Multivariate Analysis Physical therapy Female business |
| Zdroj: | Clinical Rheumatology. 35:2955-2966 |
| ISSN: | 1434-9949 0770-3198 |
| DOI: | 10.1007/s10067-016-3425-4 |
| Popis: | Anti-tumor necrosis factors (Anti-TNFs) are a class of biologic disease-modifying anti-rheumatic drugs indicated for the treatment of moderate-to-severe psoriatic arthritis (PsA). Refractory patients are commonly managed by switching from one anti-TNF to another. To assess the evidence on the effectiveness of anti-TNF cycling in PsA patients, a systematic review of the literature was conducted. MEDLINE- and Embase-indexed English-language publications were systematically searched from 1995 to 2015 for studies assessing real-world effectiveness outcomes of anti-TNF cycling in PsA patients. Of 1086 citations identified, 18 studies were included; most conducted in Europe. Six of seven studies testing between lines found significant differences in effectiveness between earlier and subsequent lines of anti-TNF therapy. First-line therapy yielded better results compared with second-line therapy, and significant differences were observed between second- and third-line anti-TNF treatments. In the only study with multivariate regression testing for predictors of response, Danish registry patients were less likely to respond (American College of Rheumatology 20 % or 50 % response) to a second anti-TNF course if safety, rather than lack of effect, caused them to switch (odds ratio [OR] 0.04; p = 0.003 and OR 0.05; p = 0.03, respectively). Effectiveness of anti-TNFs at second line and later is reported in a small number of real-world studies of PsA patients. Subsequent treatment lines may be associated with less response in some measures. More research is needed to quantify the effectiveness of sequential anti-TNF lines in this progressive population' and to compare these effects with responses to drugs with different mechanisms of action. |
| Databáze: | OpenAIRE |
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