Effectiveness of a Second Biologic After Failure of a Non-tumor Necrosis Factor Inhibitor As First Biologic in Rheumatoid Arthritis
| Autor: | Dan Nordström, Tore K Kvien, Lene Dreyer, Nina Trokovic, Karin Hellgren, Katerina Chatzidionysiou, Tanja Schjødt Jørgensen, Gerdur Grondal, Daniela Di Giuseppe, Sella Aarrestad Provan, Thomas Frisell, Lennart T H Jacobsson, Bjorn Gudbjornsson, Johan Askling, Lars Erik Kristensen, Eirik Kristianslund, Kalle Aaltonen, Merete Lund Hetland, Ritva Peltomaa, Bente Glintborg |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Immunology Biologics Disease activity Arthritis Rheumatoid 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Tocilizumab Rheumatology Internal medicine medicine Immunology and Allergy Humans In patient Registries Rheumatoid arthritis 030304 developmental biology 030203 arthritis & rheumatology 0303 health sciences Biological Products business.industry Abatacept Primary response medicine.disease 3. Good health chemistry Antirheumatic Agents Disease-modifying antirheumatic drugs Tumor necrosis factor alpha Rituximab Tumor Necrosis Factor Inhibitors Therapy business medicine.drug |
| Zdroj: | Chatzidionysiou, K, Hetland, M L, Frisell, T, Di Giuseppe, D, Hellgren, K, Glintborg, B, Nordström, D, Peltomaa, R, Aaltonen, K, Trokovic, N, Kristianslund, E K, Kvien, T K, Provan, S A, Gudbjornsson, B, Grondal, G, Dreyer, L, Kristensen, L E, Jørgensen, T S, Jacobsson, L T H & Askling, J 2021, ' Effectiveness of a second biologic after failure of a non-tumor necrosis factor inhibitor as first biologic in rheumatoid arthritis ', Journal of Rheumatology, vol. 48, no. 10, jrheum.201467, pp. 1512-1518 . https://doi.org/10.3899/jrheum.201467 |
| ISSN: | 0315-162X |
| Popis: | ObjectiveIn rheumatoid arthritis (RA), evidence regarding the effectiveness of a second biologic disease-modifying antirheumatic drug (bDMARD) in patients whose first-ever bDMARD was a non–tumor necrosis factor inhibitor (TNFi) bDMARD is limited. The objective of this study was therefore to assess the outcome of a second bDMARD (non-TNFi: rituximab [RTX], abatacept [ABA], or tocilizumab [TCZ], separately; and TNFi) after failure of a non-TNFi bDMARD as first bDMARD.MethodsWe identified patients with RA from the 5 Nordic biologics registers who started treatment with a non-TNFi as first-ever bDMARD but switched to a second bDMARD. For the second bDMARD, we assessed drug survival (at 6 and 12 months) and primary response (at 6 months).ResultsWe included 620 patients starting a second bDMARD (ABA 86, RTX 40, TCZ 67, and TNFi 427) following failure of a first non-TNFi bDMARD. At 6 and 12 months after start of their second bDMARD, approximately 70% and 60%, respectively, remained on treatment, and at 6 months, less than one-third of patients were still on their second bDMARD and had reached low disease activity or remission according to the Disease Activity Score in 28 joints. For those patients whose second bMDARD was a TNFi, the corresponding proportion was slightly higher (40%).ConclusionThe drug survival and primary response of a second bDMARD in patients with RA switching due to failure of a non-TNFi bDMARD as first bDMARD is modest. Some patients may benefit from TNFi when used after failure of a non-TNFi as first bDMARD. |
| Databáze: | OpenAIRE |
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