Switching to etanercept in patients with rheumatoid arthritis with no response to infliximab

TNF-alpha is thought to play a pivotal role in the initiation and perpetuation of the chronic inflammatory process in rheumatoid arthritis. TNF-alpha blockers such as infliximab and etanercept are currently used in the treatment of active rheumatoid arthritis (RA) when traditional DMARDs have failed...

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Bibliographic Details
Published in:	Clinical and experimental rheumatology Vol. 25; no. 1; pp. 85 - 87
Main Authors:	DI POI, E, PERIN, A, MORASSI, M. P, DEL FRATE, M, FERRACCIOLI, G. F, DE VITA, S
Format:	Journal Article
Language:	English
Published:	Pisa Clinical and Experimental Rheumatology 2007
Subjects:	Adult Aged Anti-Inflammatory Agents - therapeutic use Antibodies, Monoclonal - therapeutic use Arthritis, Rheumatoid - drug therapy Biological and medical sciences Diseases of the osteoarticular system Drug Resistance Etanercept Female Humans Immunoglobulin G - pharmacology Immunoglobulin G - therapeutic use Immunologic Factors - pharmacology Immunologic Factors - therapeutic use Immunomodulators Inflammatory joint diseases Infliximab Male Medical sciences Middle Aged Pharmacology. Drug treatments Receptors, Tumor Necrosis Factor - therapeutic use Treatment Failure Human Immunopathology Cytokine Diseases of the osteoarticular system Autoimmune disease Inflammatory joint disease Monoclonal antibody efficacy Immunomodulator Chronic Etanercept Infliximab Rheumatoid arthritis Anticytokine Immunosuppressive agent Fusion protein Tumor necrosis factor α
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Summary:	TNF-alpha is thought to play a pivotal role in the initiation and perpetuation of the chronic inflammatory process in rheumatoid arthritis. TNF-alpha blockers such as infliximab and etanercept are currently used in the treatment of active rheumatoid arthritis (RA) when traditional DMARDs have failed and are effective in a significant proportion of patients. However, about one third are non-responders to anti-TNF-alpha. The aim of this study was to verify whether rheumatoid patients, after failing infliximab, can benefit from etanercept. We analysed 18 patients with active RA with no response to at least 3 DMARDs and where infliximab therapy had failed. The patients had received infliximab associated with methotrexate: eleven of them did not show any significant response, while seven patients, after a good response, relapsed. Etanercept was then started. EULAR criteria of response were used with calculation of activity index DAS28 at baseline, after 2 weeks, 3 months and every third month until last follow-up. A moderate or good response was achieved with etanercept in 13 out of 18 patients. From our experience, etanercept can be considered as a good alternative choice when infliximab has failed.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	0392-856X 1593-098X