Treatment response to a second or third TNF-inhibitor in RA: results from the South Swedish Arthritis Treatment Group Register.
(2008) In Rheumatology 47(4). p.507-513- Abstract
- Objectives. To study treatment response rates of RA patients undergoing second- and third-line anti-TNF therapy and to identify baseline predictors of response to second-line treatment. Methods. RA patients monitored in a prospective, observational study, having switched anti-TNF therapy once (first-time switchers, n = 337) or twice (second-time switchers, n = 36)-i.e. following failures with one antibody- and one receptor-type agent-between March 1999 and December 2006, were studied. Treatment responses at 3 months were assessed by the ACR and European League Against Rheumatism (EULAR) response criteria. Predictive potentials for response to second-line treatment of demographics, baseline disease activity measures, disease and treatment... (More)
- Objectives. To study treatment response rates of RA patients undergoing second- and third-line anti-TNF therapy and to identify baseline predictors of response to second-line treatment. Methods. RA patients monitored in a prospective, observational study, having switched anti-TNF therapy once (first-time switchers, n = 337) or twice (second-time switchers, n = 36)-i.e. following failures with one antibody- and one receptor-type agent-between March 1999 and December 2006, were studied. Treatment responses at 3 months were assessed by the ACR and European League Against Rheumatism (EULAR) response criteria. Predictive potentials for response to second-line treatment of demographics, baseline disease activity measures, disease and treatment characteristics were analysed using logistic regression. Results. ACR20 response was met by 51% of first-time and 35% of second-time switchers. Corresponding ACR50 rates were 27 and 18%; EULAR overall rates (EULAR good or moderate response) 71 and 58%; EULAR good rates 25 and 9% and 28-joint disease activity score (DAS28) remission rates 16 and 6%. Identified baseline predictors of response to second-line treatment were lower age and HAQ scores, elevated DAS28 values and having ceased the former anti-TNF treatment due to adverse events rather than inefficacy. No variable was predictive for all examined response criteria. Conclusions. Response rates of first-time anti-TNF switchers are somewhat below those of anti-TNF naïve RA patients, while the markedly inferior response rates of second-time switchers suggest other therapeutic options to be considered in this situation. Identified baseline predictors of response may be useful indicators to second-line anti-TNF therapy, but vary depending on the response criteria set studied. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1041443
- author
- Karlsson, JA LU ; Kristensen, Lars Erik LU ; C Kapetanovic, Meliha LU ; Gülfe, Anders LU ; Saxne, Tore LU and Geborek, Pierre LU
- organization
- publishing date
- 2008
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- RA, Anti-TNF, Switching, Predictors, Observational study
- in
- Rheumatology
- volume
- 47
- issue
- 4
- pages
- 507 - 513
- publisher
- Oxford University Press
- external identifiers
-
- pmid:18304941
- wos:000255520300026
- scopus:43049162899
- pmid:18304941
- ISSN
- 1462-0332
- DOI
- 10.1093/rheumatology/ken034
- language
- English
- LU publication?
- yes
- id
- 464e5a23-ff9d-4bf8-861d-254597834e08 (old id 1041443)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/18304941?dopt=Abstract
- date added to LUP
- 2016-04-01 14:47:48
- date last changed
- 2022-01-28 02:31:26
@article{464e5a23-ff9d-4bf8-861d-254597834e08,
abstract = {{Objectives. To study treatment response rates of RA patients undergoing second- and third-line anti-TNF therapy and to identify baseline predictors of response to second-line treatment. Methods. RA patients monitored in a prospective, observational study, having switched anti-TNF therapy once (first-time switchers, n = 337) or twice (second-time switchers, n = 36)-i.e. following failures with one antibody- and one receptor-type agent-between March 1999 and December 2006, were studied. Treatment responses at 3 months were assessed by the ACR and European League Against Rheumatism (EULAR) response criteria. Predictive potentials for response to second-line treatment of demographics, baseline disease activity measures, disease and treatment characteristics were analysed using logistic regression. Results. ACR20 response was met by 51% of first-time and 35% of second-time switchers. Corresponding ACR50 rates were 27 and 18%; EULAR overall rates (EULAR good or moderate response) 71 and 58%; EULAR good rates 25 and 9% and 28-joint disease activity score (DAS28) remission rates 16 and 6%. Identified baseline predictors of response to second-line treatment were lower age and HAQ scores, elevated DAS28 values and having ceased the former anti-TNF treatment due to adverse events rather than inefficacy. No variable was predictive for all examined response criteria. Conclusions. Response rates of first-time anti-TNF switchers are somewhat below those of anti-TNF naïve RA patients, while the markedly inferior response rates of second-time switchers suggest other therapeutic options to be considered in this situation. Identified baseline predictors of response may be useful indicators to second-line anti-TNF therapy, but vary depending on the response criteria set studied.}},
author = {{Karlsson, JA and Kristensen, Lars Erik and C Kapetanovic, Meliha and Gülfe, Anders and Saxne, Tore and Geborek, Pierre}},
issn = {{1462-0332}},
keywords = {{RA; Anti-TNF; Switching; Predictors; Observational study}},
language = {{eng}},
number = {{4}},
pages = {{507--513}},
publisher = {{Oxford University Press}},
series = {{Rheumatology}},
title = {{Treatment response to a second or third TNF-inhibitor in RA: results from the South Swedish Arthritis Treatment Group Register.}},
url = {{http://dx.doi.org/10.1093/rheumatology/ken034}},
doi = {{10.1093/rheumatology/ken034}},
volume = {{47}},
year = {{2008}},
}