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Arthritis Research & Therapy (1)
Clinical Rheumatology (1)
Antoni, Christian E (1)
Antoni, Christian E. (1)
Beckmann, Christina (1)
Breedveld, Ferdinand C. (1)
Burmester, Gerd R. (1)
Gottlieb, Alice B (1)
Kalden, Joachim R. (1)
Kary, Sonja (1)
Kupper, Hartmut (1)
Unnebrink, Kristina (1)
van der Bijl, Arie E. (1)
Year of Publication
An open-label pilot study of the effectiveness of adalimumab in patients with rheumatoid arthritis and previous infliximab treatment: relationship to reasons for failure and anti-infliximab antibody status
van der Bijl, Arie E.
Breedveld, Ferdinand C.
Kalden, Joachim R.
Burmester, Gerd R.
This prospective open-label pilot study evaluated the effectiveness and safety of adalimumab and the relationship to antibodies against infliximab (IFX) in adult patients with active rheumatoid arthritis (RA) who had been treated previously with IFX and experienced treatment failure owing to lack or loss of response or intolerance. Patients self-administered adalimumab 40 mg subcutaneously every other week for 16 weeks, followed by maintenance therapy for up to Week 56. Measures of effectiveness included American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) response criteria, 28-joint Disease Activity Score, and the Health Assessment Questionnaire Disability Index. Serum IFX concentrations, human antichimeric antibody against IFX (HACA), adalimumab serum concentrations, antiadalimumab antibody, and safety also were assessed. Of the 41 enrolled patients, 37 completed 16 weeks and 30 completed 56 weeks of treatment. Patients experienced clinically meaningful improvements in all measures of RA activity, with greater response rates observed for patients who had experienced loss of initial response to or intolerance of IFX. At Week 16, 46% of patients achieved an ACR20 and 28% achieved an ACR50; 61% achieved an at least moderate and 17% achieved a good EULAR response. Clinical benefit was maintained through Week 56 in all effectiveness parameters. Baseline HACA status did not significantly impact effectiveness. No new safety signals were observed; neither former IFX intolerance status nor baseline HACA status had a clinically relevant impact on adverse event frequency or severity. Adalimumab was effective and well-tolerated in patients with RA who previously failed IFX therapy, irrespective of reason for discontinuation and of HACA status.
Adalimumab; Infliximab; Rheumatoid arthritis; Treatment failure; Tumor necrosis factor antagonist
Treating psoriatic arthritis: how effective are TNF antagonists?
Gottlieb, Alice B
Arthritis Research & Therapy
Psoriatic arthritis (PsA) is a seronegative spondyloarthropathy that commonly appears after the onset of the characteristic cutaneous lesions. This complication affects about 40% of patients with moderate to severe cutaneous disease. Analysis of synovial fluid and tissue in patients with PsA demonstrates a profile of high levels of tumor necrosis factor (TNF) plus other cytokines similar to those seen in patients with rheumatoid arthritis (RA). In the past, medical management of patients with this disease consisted of treatment with nonsteroidal anti-inflammatory agents. Patients with more severe disease have tried a number of different disease-modifying drugs including methotrexate, azathioprine, and gold salts. However, there is no evidence that these agents can arrest the progress of structural joint damage. Infliximab and etanercept are TNF antagonists that have demonstrated significant efficacy and safety in patients with RA. Clinical trials with these two agents in patients with PsA have shown significant improvement in the rheumatologic and cutaneous manifestations of the disease.
arthritis; etanercept; infliximab; psoriasis; spondyloarthropathies; tumor necrosis factor
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